Diagnosis and treatment of persistent dysphonia after laryngeal surgery: a retrospective analysis of 62 patients

Abstract

Sixty-two patients with persistent or recurrent dysphonia after laryngeal surgery underwent interdisciplinary voice evaluation, laryngostroboscopy, and objective measurements of vocal function. The causes of persistent dysphonia were attributed to vocal fold scarring (n = 22), residual mass lesion (n = 8), residual inflammation (n = 13), recurrent mass (n = 4), and hyperfunctional voice disorder (n = 7). Laryngoscopy often showed excessive ventricular compression and anterior-to-posterior laryngeal compression. Ventricular dysphonia was often a compensatory gesture in response to poorly mobile vocal fold membranes. Stroboscopy was able to document a number of abnormalities which included abnormalities of laryngeal configuration, vibratory asymmetry, reduction of amplitude, and mucosal wave. Using a diversified approach consisting of medical therapy, voice therapy, and repeat surgery, better vocal function was able to be restored in the majority of patients. An interdisciplinary approach to the dysphonic patient after laryngeal surgery was most useful in defining the pathology and refining a treatment rehabilitation program.