성대 폴립 환자에서 음성위생교육의 효과

Abstract

Background and Objectives：Surgical removal is generally known as the gold standard treatment of vocal polyp. However, the authors have not infrequently observed marked reduction or complete disappearance of the vocal polyps when vocal hygiene education was provided as a part of preoperative routine preparation. The aim of this study was to assess the effect of vocal hygiene education and to define the factors that can predict which patients with vocal polyp will get benefits from it. Subjects and Method：We reviewed the medical records of 190 patients with vocal polyp, and selected 88 patients who had received vocal hygiene education and completed a series of follow-up evaluation at 3 months later. According to the change of polyp size, patients were grouped into two：improvement and no improvement group. Eight factors (age, gender, duration of hoarseness, initial polyp size, hemorrhagic change of vocal polyp, degree of occupational voice abuse, smoking, and presence of reflux symptoms) were compared between the two groups. Results：When given the vocal hygiene education, 19% of overall 190 patients and 41% of 88 patients who were followed up belonged to the improvement group. Univariate analyses showed that female patients, shorter duration of hoarseness, smaller polyp size, less occupational voice abuse, and no smoking are the meaningful favorable predictive factors. Multivariate analyses demonstrated that female patients with a small polyp and no symptoms of reflux have the largest possibility of getting improved. Conclusion：Vocal hygiene education should be providedas a first line of treatment for patients with vocal polyp, especially when a female patient without reflux symptom has a small polyp. (Korean J Otolaryngol 2006;49:728-32)