Autoimmune Associated Vocal Fold Lesions: A Systematic Review

Area of Science:

• Otolaryngology
• Rheumatology
• Immunology

Background:

• Autoimmune Associated Vocal Fold Lesions (AaVFLs) are increasingly recognized but lack standardized management protocols.
• Dysphonia is a common symptom associated with AaVFLs, impacting patient quality of life.

Purpose of the Study:

• To systematically review the characteristics and treatment outcomes of dysphonia in patients with AaVFLs.
• To provide insights into optimal management strategies for AaVFLs.

Main Methods:

• A systematic literature search was conducted across PubMed, OvidMedline, and Google Scholar.
• Keywords included vocal fold lesions, rheumatoid nodules, and autoimmune/connective tissue diseases.

Main Results:

• Eighty-three patients across 21 studies were analyzed, with AaVFLs predominantly affecting females in their 4th-5th decade.
• Bilateral lesions were common (83.8%), and 75.9% had a pre-existing autoimmune diagnosis.
• Voice therapy, alone or in combination, yielded the highest rates of voice improvement.

Conclusions:

• AaVFLs are associated with various autoimmune conditions and primarily impact middle-aged women.
• A notable percentage of patients (25%) lack an established autoimmune diagnosis upon otolaryngologist presentation.
• Voice therapy demonstrates significant efficacy in improving voice quality and function for AaVFLs patients.