Patient Experience With Absolute Voice Rest Following Phonomicrosurgery: A Qualitative Study

Objective(s): Voice rest is commonly recommended following phonomicrosurgery to minimize vocal fold scarring, but associated quality of life (QoL) is low resulting in poor compliance. This study aimed to explore patients' experiences with voice rest following phonomicrosurgery to identify facilitators and barriers.

Methods: This qualitative study used prospective, typical case technique for purposive sampling of consecutive patients who underwent voice rest following phonomicrosurgery for benign vocal fold lesions. Participants were enrolled at a single tertiary Laryngology center located at Unity Health Toronto - St. Michael's Hospital from 2020 to 2022. Semi-structured virtual interviews were conducted 4 weeks following patients' surgery. All interview transcripts were transcribed verbatim and underwent thematic analysis. Participant recruitment was stopped once thematic saturation was achieved.

Results: Twenty participants were recruited and 4 withdrew due to scheduling conflicts. Sixteen participants completed interviews, all of whom reported minimal impact of postoperative voice rest on QoL. The participants attributed their success to facilitators such as notifying close contacts of their situation beforehand and adopting nonverbal forms of communication. No participant endorsed a negative attitude toward voice rest. Understanding the rationale for voice rest and the consequences of noncompliance were reported to be effective in encouraging compliance.

Conclusion: Overall, the participants tolerated voice rest well owing to facilitators such as early preparation, lifestyle modifications, and understanding the rationale for voice rest. Social disconnect and work demands were barriers of voice rest. Moving forward, facilitators and barriers should be addressed in efforts to optimize the voice rest experience for future patient populations.

Level of evidence: 4 Laryngoscope, 134:361-366, 2024.