Efficacy of Voice Therapy for Vocal Fold Masses: Avoidance of Surgery

Voice abuse and misuse are the most common causes of benign vocal fold lesions (BVFL). Treatment may include a combination of voice therapy, singing sessions, or surgical resection. Otolaryngologists and speech language pathologists advocate for preoperative, as well as postoperative, voice therapy.

To determine the efficacy of voice therapy in avoiding the need for surgery.

This study was a retrospective chart review of patients who were seen in the office at Philadelphia Ear, Nose and Throat Associates and were diagnosed with BVFL from January 1, 2010 to December 31, 2022. Information gathered from patient charts included past laryngeal medical/surgical history, BVFL pathology or subtype and description, voice intervention (type and dates of intervention), voice therapy outcomes, singing sessions, and voice surgery and characteristics of preoperative voice therapy, among other information. Data were then analyzed using statistics for relationships and significance.

One hundred twenty-seven patients met inclusion criteria for this analysis. Seventy-nine patients were included in the nonsurgical intervention group, while 48 underwent voice therapy (defined as voice therapy or singing sessions) and progressed to surgery. Professional voice users between the two groups were similar, but a higher percentage of singers were present in the surgical group. Sex and lesion type agreed with previous literature for most lesions, with a higher number of polyps in females differing from literature. Patients in the non-surgical group had longer duration and number of voice therapy sessions.

Patients undergoing nonsurgical intervention (voice therapy or singing sessions) are less likely to have complete improvement as compared with their surgical counterparts, but the number of patients undergoing voice therapy over surgical options suggests voice therapy is still a valuable option for patients.