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Postoperative Betreuung in der operativen Laryngologie

Postoperative care in operative laryngology

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Zusammenfassung

Die postoperative Betreuung von phonochirurgisch und laryngologisch behandelten Patienten aus ärztlicher Sicht bezieht sich auf die Kontrolle des Verlaufs der Wundheilung und die Feststellung der Restitution der operierten Stimmlippen oder des Kehlkopfes. Der Arzt gibt Hinweise zum Verhalten des Patienten und verordnet ggf. Medikamente und heilungsfördernde Maßnahmen, wie Stimmruhe und Arbeitsunfähigkeit. Die grundlegenden Kenntnisse zur Wundheilung helfen bei der Bestimmung, zu welchem Zeitpunkt die Stimmruhe und die Arbeitsunfähigkeit beendet werden können. Menschen in Stimmhochleistungsberufen brauchen spezifische Hinweise zur Stimmrehabilitation. Die Dokumentation umfasst den organischen Befund und die Stimmfunktion.

Abstract

The postoperative care after phonosurgery and laryngologic procedures from the physician’s view comprises control of wound healing and confirmation of restitution of the vocal folds or the larynx. The physician manages the patient’s behaviour, prescribes medication if necessary and provides advice on measures to promote healing, such as voice rest and work incapacity. Basic knowledge on wound healing is an aid for deciding at which point in time voice rest and work incapacity can be ended. Professional voice users need a specifically tailored line of conduct during the period of voice rehabilitation. The documentation includes the organic findings and the vocal function.

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Literatur

  1. Behrman A, Sulica L (2003) Voice rest after microlaryngoscopy: current opinion and practice. Laryngoscope 113: 2182–2186

    Article  PubMed  Google Scholar 

  2. Behrman A, Rutledge J, Hembree A, Sheridan S (2008) Vocal hygiene education, voice production therapy, and the role of patient adherence: a treatment effectiveness study in women with phonotrauma. J Speech Lang Hear Res 51: 350–366

    Article  PubMed  Google Scholar 

  3. Belafsky PC, Postma GN, Koufman JA (2001) The validity and reliability of the reflux finding score (RFS). Laryngoscope 111: 1313–1317

    Article  PubMed  CAS  Google Scholar 

  4. Belafsky PC, Postma GN, Koufman JA (2001) Laryngopharyngeal reflux symptoms improve before changes in physical findings. Laryngoscope 111: 979–981

    Article  PubMed  CAS  Google Scholar 

  5. Belafsky PC, Postma GN, Koufman JA (2002) Validity and reliability of the reflux symptom index (RSI). J Voice 16: 274–277

    Article  PubMed  Google Scholar 

  6. Bove MJ, Rosen C (2006) Diagnosis and management of laryngopharyngeal reflux disease. Curr Opin Otolaryngol Head Neck Surg 14: 116–123

    Article  PubMed  Google Scholar 

  7. Bovo R, Galceran M, Petruccelli J, Hatzopoulos S (2007) Vocal problems among teachers: evaluation of a preventive voice program. J Voice 21: 705–722

    Article  PubMed  Google Scholar 

  8. Branski RC, Verdolini K, Sandulache V et al. (2006) Vocal fold wound healing: A review for clinicians. J Voice 20: 432–442

    Article  PubMed  Google Scholar 

  9. Broaddus-Lawrence PL, Treole K, McCabe RB et al. (2000) The effects of preventive vocal hygiene education on the vocal hygiene habits and perceptual vocal characteristics of training singers. J Voice 14: 58–71

    Article  PubMed  CAS  Google Scholar 

  10. Bundesausschuss der Ärzte und Krankenkassen (2004) Richtlinien des Bundesausschusses der Ärzte und Krankenkassen über die Beurteilung der Arbeitsunfähigkeit und die Maßnahmen zur stufenweisen Wiedereingliederung (Arbeitsunfähigkeits-Richtlinien). Bundesanzeiger 61: 6501

    Google Scholar 

  11. Cho SH, Kim HT, Lee IJ et al. (2000) Influence of phonation on basement membrane zone recovery after phonomicrosurgery: a canine model. Ann Otol Rhinol Laryngol 109: 658–666

    PubMed  CAS  Google Scholar 

  12. Colton RH, Casper JK (2006) Understanding voice problems: a physiological perspective for diagnosis and treatment. Lippincott Williams & Wilkins, Baltimore

  13. Dejonckere PH, Bradley P, Clemente P et al. (2001) A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS). Eur Arch Otorhinolaryngol 258: 77–82

    Article  PubMed  CAS  Google Scholar 

  14. Elwany S, Nour YA, Magdy EA (2008) Does laryngopharyngeal reflux affect healing and recovery after tonsillectomy? J Laryngol Otol 122: 603–608

    Article  PubMed  CAS  Google Scholar 

  15. Ford CN (2005) Evaluation and management of laryngopharyngeal reflux. JAMA 294: 1534–1540

    Article  PubMed  CAS  Google Scholar 

  16. Friedrich G, Dejonckere PH (2005) Das Stimmdiagnostik-Protokoll der European Laryngological Society (ELS) – erste Erfahrungen im Rahmen einer Multizenterstudie. Laryngorhinootologie 84: 744–752

    Article  PubMed  CAS  Google Scholar 

  17. Gillivan-Murphy P, Drinnan MJ, O’Dwyer TP et al. (2006) The effectiveness of a voice treatment approach for teachers with self-reported voice problems. J Voice 20: 423–431

    Article  PubMed  Google Scholar 

  18. Gonnermann U (2007) Quantifizierbare Verfahren zur Bewertung von Dysphonien – Auditive Heiserkeitsbewertung, apparative Stimmdiagnostik und Selbsteinschätzung der Stimme. Hallesche Schriften zur Sprechwissenschaft und Phonetik, Bd 23. Peter Lang, Frankfurt am Main, S 139

  19. Hansen JK, Thibeault SL (2006) Current understanding and review of the literature: vocal fold scarring. J Voice 20: 110–120

    Article  PubMed  Google Scholar 

  20. Hirano S, Bless DM, Rousseau B et al. (2003) Fibronectin and adhesion molecules on canine scarred vocal folds. Laryngoscope 113: 966–972

    Article  PubMed  CAS  Google Scholar 

  21. Hoover CA, Sataloff RT, Lyons KM, Hawkshaw M (2001) Vocal fold mucosal tears: maintaining a high clinical index of suspicion. J Voice 15: 451–455

    Article  PubMed  CAS  Google Scholar 

  22. Joniau S, Bradshaw A, Esterman A, Carney AS (2007) Reflux and laryngitis: a systematic review. Otolaryngol Head Neck Surg 136: 686–692

    Article  PubMed  Google Scholar 

  23. Klein AM, Lehmann M, Hapner ER, Johns MM, 3rd (2008) Spontaneous resolution of hemorrhagic polyps of the true vocal fold. J Voice 2008 10 Jan, epub ahead of print

  24. Lim X, Tateya I, Tateya T et al. (2006) Immediate inflammatory response and scar formation in wounded vocal folds. Ann Otol Rhinol Laryngol 115: 921–929

    PubMed  Google Scholar 

  25. Mahieu HF (2007) Review article: The laryngological manifestations of reflux disease; why the scepticism? Aliment Pharmacol Ther 26 (Suppl 2): 17–24

    Article  PubMed  Google Scholar 

  26. Murry T, Rosen CA (2000) Phonotrauma associated with crying. J Voice 14: 575–580

    Article  PubMed  CAS  Google Scholar 

  27. Nawka T, Evans R (2003) Stimmstatus und Dysphonie-Schweregrad-Index (DSI) – Diagnostische Möglichkeiten bei Stimmstörungen. In: Anders LC, Hirschfeld U (Hrsg) Sprechsprachliche Kommunikation. Peter Lang, Frankfurt am Main, S 221–229

  28. Nawka T, Wiesmann U, Gonnermann U (2004) Validierung der deutschen Fassung des Voice Handicap Index. HNO 51: 921–929

    Article  Google Scholar 

  29. Nawka T, Hosemann W (2005) Wiederherstellende chirurgische Verfahren bei gestörter Stimme. Laryngorhinootologie 84: 201–212

    Article  Google Scholar 

  30. Nawka T, Wirth G (2008) Stimmstörungen. Deutscher Ärzte-Verlag, Köln, S 452

  31. Park W, Hicks DM, Khandwala F et al. (2005) Laryngopharyngeal reflux: prospective cohort study evaluating optimal dose of proton-pump inhibitor therapy and pretherapy predictors of response. Laryngoscope 115: 1230–1238

    Article  PubMed  CAS  Google Scholar 

  32. Pasa G, Oates J, Dacakis G (2007) The relative effectiveness of vocal hygiene training and vocal function exercises in preventing voice disorders in primary school teachers. Logoped Phoniatr Vocol 32: 128–140

    Article  PubMed  Google Scholar 

  33. Pedersen M, Beranova A, Moller S (2004) Dysphonia: medical treatment and a medical voice hygiene advice approach. A prospective randomised pilot study. Eur Arch Otorhinolaryngol 261: 312–315

    Article  PubMed  CAS  Google Scholar 

  34. Remacle M, Eckel HE, Antonelli A et al. (2000) Endoscopic cordectomy. A proposal for a classification by the working committee, european laryngological society. European Archives of Otorhinolaryngology 257: 227–231

    Article  PubMed  CAS  Google Scholar 

  35. Rousseau B, Hirano S, Chan RW et al. (2004) Characterization of chronic vocal fold scarring in a rabbit model. J Voice 18: 116–124

    Article  PubMed  Google Scholar 

  36. Roy N, Weinrich B, Gray SD et al. (2002) Voice amplification versus vocal hygiene instruction for teachers with voice disorders: a treatment outcomes study. J Speech Lang Hear Res 45: 625–638

    Article  PubMed  Google Scholar 

  37. Rubin AD, Praneetvatakul V, Gherson S et al. (2006) Laryngeal hyperfunction during whispering: reality or myth? J Voice 20: 121–127

    Article  PubMed  Google Scholar 

  38. Stemple JC, Glaze L, Klaben BG (2000) Clinical voice pathology. Singular Thomson Learning, San Diego

  39. Thibeault SL, Smith ME, Peterson K, Ylitalo-Moller R (2007) Gene expression changes of inflammatory mediators in posterior laryngitis due to laryngopharyngeal reflux and evolution with PPI treatment: a preliminary study. Laryngoscope 117: 2050–2056

    Article  PubMed  Google Scholar 

  40. Timmermans B, De Bodt MS, Wuyts FL, Van de Heyning PH (2004) Training outcome in future professional voice users after 18 months of voice training. Folia Phoniatr Logop 56: 120–129

    Article  PubMed  Google Scholar 

  41. Timmermans B, Vanderwegen J, De Bodt MS (2005) Outcome of vocal hygiene in singers. Curr Opin Otolaryngol Head Neck Surg 13: 138–142

    Article  PubMed  Google Scholar 

  42. Welham NV, Lim X, Tateya I, Bless DM (2008) Inflammatory factor profiles one hour following vocal fold injury. Ann Otol Rhinol Laryngol 117: 145–152

    PubMed  Google Scholar 

  43. Yun YS, Kim MB, Son YI (2007) The effect of vocal hygiene education for patients with vocal polyp. Otolaryngol Head Neck Surg 137: 569–575

    Article  PubMed  Google Scholar 

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  1. HNO-Klinik, Phoniatrie und Pädaudiologie, Ernst-Moritz-Arndt-Universität, Walther-Rathenau-Straße 43-45, 17475, Greifswald, Deutschland

    T. Nawka

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Nawka, T. Postoperative Betreuung in der operativen Laryngologie. HNO 56, 1183–1189 (2008). https://doi.org/10.1007/s00106-008-1726-x

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