Clinical Validation of a Nomenclature Paradigm for Benign Vocal Folds Lesions
Jackie Gartner-Schmidt, Clark A. Rosen, Bridget Hathaway, C. Blake Simpson, Gregory N. Postma, Mark Courey, Robert T. Sataloff
Great confusion exists regarding nomenclature for benign vocal fold lesions (BVFL). This confusion results in difficulty for clinicians communicating with their patients and with each other. An initial BVFL nomenclature paradigm was proposed utilizing vocal fold lesion morphology, stroboscopy, response to voice therapy and intraoperative findings. Video perceptual analysis of stroboscopy demonstrated that the proposed binary stroboscopy system utilized in the BVFL nomenclature paradigm was valid and widely applicable. Retrospective review of 45 patients with BVFL followed through the conclusion of treatment demonstrated that slight modifications of the initial BVFL nomenclature paradigm were required. With the modified BVFL nomenclature paradigm, only three of 45 patients did not fit into the predicted pattern/definitions of the BVFL nomenclature system. In addition, it was found that 62% of the patients achieved improvement or resolution of their voice condition with non-surgical/conservative treatment (e.g., voice therapy).
This study created and validated the first multi-dimensional bilateral vocal fold lesion nomenclature paradigm. This vocal fold paradigm includes eight distinct vocal fold lesions, including vocal fold nodules, vocal fold polyp, pseudocyst, vocal fold cyst (subepithelial or ligament), vocal fold fibrous mass (subepithelial or ligament) and reactive lesion.
Clark A. Rosen, M.D. rosenca@upmc.edu
Bridget Hathaway, M.D. hathbc@upmc.edu
JackieGartner-Schmidt, Ph.D. gartnerschmidtjl@upmc.edu
University of Pittsburgh Department of Otolaryngology
200 Lothrop Street, Suite 500
Pittsburgh, PA 15213
412-647-2112 Fax 412-647-2080
C. Blake Simpson, M.D.
Otolaryngology-H&N Surgery
University of Texas Health Sciences Center
7703 Floyd Curl Drive, MSC-7777
San Antonio, TX 78229-3900
210-567-6520 Fax 210-567-3617
simpsonc@uthscsa.edu
Gregory N. Postma, M.D.
Department of Otolaryngology
MedicalCollege of Georgia
1120 15th Street
Augusta, GA 30912
706-721-6100 Fax 706-721-0112
gpostma@mcg.edu
Mark Courey, M.D.
UCSF Voice & Swallowing Center
2330 Post Street, 5th Floor
San Francisco, CA 94115
(415) 885-7700 Fax (415) 885-7800
mcourey@ohns.ucsf.edu
Robert T. Sataloff, M.D., DMA
PhiladelphiaENT Associates
1721 Pine Street
Philadelphia, PA 19103-6771
(215) 545-3322 fax (215) 790-1192
rtsataloff@phillyent.com