Influencia de los factores epidemiológicos en la evolución de los pacientes con nódulos vocales tras el tratamiento vocal

Abstract

Objective: To investigate the influence of various epidemiological factors in the evolution of patients with vocal nodules after vocal rehabilitation treatment. Material and Methods: We performed a prospective study of 97 dysphonic patients diagnosed of vocal nodules, over a five years period, focusing more on the related epidemiologic factors. When the vocal treatment was concluded, we classified the patients into two groups (clinical improvement / no clinical improvement) based on the evolution of the objective, subjective and perceptual measures. We analyzed the relationship between each of the listed epidemiological factors and the clinical course. Results: The factors most frequently associated with an unfavorable evolution of vocal nodules, after vocal treatment, were anxiety-depressive disorders, gastro-oesophageal reflux and a vocal behavior characterized by cervical tension and engorgement during phonation and a poor articulation of the word. Also, the evolution of older patients and those whose profession involve customer service tends to be less favorable. No relationship was found between the clinical course and smoking, breathing type, onset form of dysphonia and the location of the nodules. Discussion: We try to explain the influence of these factors on the clinical course and we review the existing literature.