Voice rest after vocal fold polyp surgery: A Swedish register study of 588 patients

To evaluate the impact of voice rest on patient-reported voice outcome 4 months after vocal fold polyp surgery.

Preoperative information was collected about age, sex, and smoking habits and the voice handicap index-10 (VHI-10). Four months postoperatively, voice rest (total voice rest, spoke single words, and spoke normally), and pre and postoperative voice therapy were reported. This was correlated to voice satisfaction from a two-category subjective evaluation "satisfied/ not satisfied" and to VHI-10. Logistic regression models with relative risk for NOT being satisfied with voice after surgery were performed.

Data from 588 patients were available. The group "spoke normally" showed the highest degree of patient satisfaction (92%). Younger patients (<59 years) were more satisfied than older (90% vs. 81.5%). High age and low VHI-10 scores before surgery were statistically significant for negative voice outcome. Gender or voice rest type did not significantly affect outcome. The largest improvement in VHI-scores was in the group who spoke normally and least in the group who spoke single words.

We found no significant difference in the two-category subjective voice outcome depending on voice rest. VHI-10 showed a statistically significant positive effect on self-evaluated voice outcome, with the largest improvement in the group with no voice rest. However, the clinical relevance of the VHI changes is unclear. The present study does not show any advantage of total voice rest as compared to relative voice rest or speaking freely. High age and low preoperative VHI scores were significant risk factors for worse voice outcome. Level of evidence: 4.