Patient Report Versus Instrumental Measurement of Voice Use During Postsurgical Voice Rest

Complete or relative voice rest is recommended following phonomicrosurgery. Primarily, adherence to rest has been measured using patient reports, but their validity is unknown. Instrumental measures of rest adherence are uncommon. Furthermore, to our knowledge, subjectively and instrumentally measured voice rest has not been compared in voice patients. We aimed to compare patient-reported voice use (daily and overall schedules) to concurrent dosimeter readings in postsurgical patients prescribed complete or relative voice rest.

Sixteen women (M = 45.88 years, SD = 15.39, range: 21-69 years) and seven men (M = 46.43 years, SD = 13.43, range: 31-70 years) who underwent microflap phonosurgery for a primary benign vocal fold lesion were randomized to complete or relative rest, controlling for sex and lesion type. Postoperatively, they wore a VocaLog2 Vocal Activity Monitor for a 7-day voice rest period and used a visual analog scale to record daily and overall subjective adherence. Within-subjects (daily/overall report) and between-subjects (relative/complete rest) factors were compared using analysis of variance; dosimeter data were the outcome variable.

For both groups, daily (F _1,42 = 4.34, p = 0.04) and overall (F _1,42 = 4.38, p = 0.04) subjective ratings significantly differed from dosimeter data. The least-squares-adjusted means indicated that both groups' subjective estimates were 79-83 standardized units lower than the instrumental data across both time points.

Subjective patient reports of adherence should be carefully considered. The duration of voice use did not differ by the type of voice rest recommended.