Effects of Different Voice Rest on Vocal Function After Microlaryngeal Surgery: A Systematic Review and Meta-Analysis
The Laryngoscope
Chi, H. W., Cho, H. C., et al. (2023).
The Laryngoscope, 133(1), 154-161.
This systematic review and meta-analysis explores the effects of short-term (<7 days) versus long-term (<span style="text-decoration: underline;">></span>7 days) vocal rest following microlaryngeal surgery.
Cardinal Tien Hospital, Taiwan
From database inception to March 1, 2021
Randomized controlled trials
4
<div>The following results were noted for short-duration (<7 days) vocal rest versus long-duration (<span style="text-decoration: underline;">></span> 7 days) following microlaryngeal surgery:</div>
<ul>
<li><span style="color: #333333;">Voice Handicap Index (VHI) scores (MD= -7.01, 95% CI= -16.12 to 2.09; p = 0.13) were generally comparable between groups, however, subgroup analysis favored short-duration vocal rest for patients with benign pathologies (MD= -14.45, 95% CI= -26.19 to -2.72; p = 0.02) and for patients receiving surgery with cold instruments (i.e., non-heat producing techniques rather than lasers; MD= -15.98, 95% CI= -28.52 to -3.44, p= 0.01);</span></li>
<li><span style="color: #333333;">Maximum phonation time outcomes (MD= -2.58, 95% CI= -5.42 to 0.26, p= 0.07) were not significantly different between groups;</span></li>
<li><span style="color: #333333;">Acoustic variables of jitter (MD= -1.25, 95% CI= -3.43 to 0.94, p= 0.26) and shimmer ( MD= -0.79, 95% CI= -2.08 to 0.51, p+ 0.24) were not significantly different between groups; </span></li>
<li><span style="color: #333333;">Participants reported greater difficulty in complying with prescribed vocal rest in the long-duration (90%) versus the short-duration (30%) group; and </span></li>
<li><span style="color: #333333;">Significantly higher daily frustration scores were noted in the long-duration group in one study. </span></li>
</ul>
<div>In summary, short-duration vocal rest was associated with comparable acoustic measures and equal or improved voice-related quality of life outcomes when compared to long-duration vocal rest, however, equal or superior outcomes were noted for short-deuration vocal rest regarding quality of life. Limitations to this review include heterogeneity in included study designs and overall paucity of evidence.</div>
