Boogaard, J.J.A. (2017) Investigating voice outcomes after treating benign mid-membranous vocal fold lesions using a validated stratification system. thesis, Medicine.
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Abstract
Background: Interpretation of treatment outcomes of voice disorders following benign midmembranous vocal fold lesions (BMVFLs) is difficult since a standardized nomenclature system is lacking. The aim of this study was to investigate outcomes of patients with BMVFLs using a previously validated stratification system, while also providing incidences and outcome results for each diagnosis. Methods: A retrospective chart review of BMVFL patients was performed at the University of Pittsburgh Medical Center from January 2009 to June 2014. Patients ≥ 18 years of age and a primary diagnosis of BMVFL were included. Treatment typically involved implementation of nonsurgical therapy followed by phonomicrosurgery. A previously reported BMVFL nomenclature system for stratification of lesions was used. Statistical analysis included descriptive analysis, paired sampled t-test and Wilcoxon signed-rank test. Results: Initially 251 patients with BMVFLs were studied, whereof 224 were included in this study of which 150 patients underwent phonomicrosurgery. In the included study group the most common BMFVL types were polyp (30.8%), non-specific vocal fold lesions (NSVFL, 24.1%) and fibrous mass-subepithelial (FB-SE, 21.4%). Pseudocyst represented 0.9% of the cohort. Significant p values were demonstrated with the Voice Handicap Index-10 (VHI-10) and acoustic data. Average change in VHI-10 was greatest for polyp, cyst–subepithelial, and FB-SEs. Fibrous mass–ligamentous patients showed the smallest mean change in VHI-10. Average post-treatment VHI-10 scores of all the lesions were within normal limits (<11) except for fibrous mass–ligamentous lesions. Conclusions: Ligamentous fibrous mass lesions have a decreased response to treatment compared to all other lesions. This study demonstrates the ability to return most BMVFL patients to normal speaking voice capabilities following treatment. This study represents the first outcomes-based report of BMVFLs using a strictly defined stratification system of BMVFL lesions.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty Supervisors: and Kallenberg, Prof. dr. C.G.M. Professor of Clinical Immunolog and F.G. Dikkers, Prof. dr. Professor of General Otorhinolaryngo |
| Supervisor name: | Supervisors: and Rosen, Dr. C.A Professor of otolaryngology and Ferris, Dr. R.L Professor of otolaryngology and immunology and Department of Otolaryngology, University of Pittsburgh Medic and Pittsburgh, Pennsylvania |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:07 |
| Last Modified: | 25 Jun 2020 11:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2688 |
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