Endoscopic Vocal Fold Microflap: A Three-Year Experience

Abstract

Surgical techniques for the removal of vocal fold (VF) disorders that arise within the lamina propria must permit the preservation and/or restoration of VF vibratory characteristics. The endoscopic VF microflap is designed to do such. A retrospective study was undertaken to evaluate the efficacy of this procedure. Forty microflaps (7 bilateral, 1 revision) were performed on 32 patients. Charts and surgical pathology findings were reviewed. Preoperative and 3-month postoperative video recorded voice samples and stroboscopic examination results were compared. Findings on perceptual voice analysis did not significantly change. Stroboscopic examinations revealed improved postoperative VF closure in 27 of 29 patients with impaired preoperative closure and return of mucosal wave in 18 of 24 VFs operated on for the excision of cysts or polyps. When present preoperatively (6 patients), the mucosal wave was preserved. Most patients (28 of 30) rated themselves as clinically improved. The endoscopic VF microflap is efficacious in the treatment of selected VF disorders. The surgical technique is discussed.

Keywords

glottis laryngeal microflap mucosal wave polypoid corditis Reinke's edema vocal fold cyst

Get full access to this article

View all access options for this article.

References

Titze

Talkin

. A theoretical study of the various laryngeal configurations on the acoustics of phonation. J Acoust Soc Am 1979; 66: 60–74.

Titze

. Comments on the my oelastic-aerodynamic theory of phonation. J Speech Hear Res 1980; 23: 495–510.

Hirano

. Surgical anatomy and physiology of the vocal folds. In: Gould

Sataloff

Spiegel

, eds. Voice surgery. Chicago, Ill: Mosby Year Book, 1993: 125–58.

Sataloff

. The professional voice. In: Cummings

Fredrickson

Harker

Krause

Schuller

, eds. Otolaryngology–head and neck surgery. Vol 3. St Louis, Mo: Mosby, 1986: 2029–56.

Courey

Ossoff

. Surgical management of benign voice disorders. In: Gould

Rubin

Korovin

Sataloff

, eds. Diagnosis and treatment of voice disorders. New York, NY: Igaku-Shoin (in press).

Hirano

Yoshida

Hirade

Sanada

. Improved surgical technique for epidermoid cysts of the vocal fold. Ann Otol Rhinol Laryngol 1989; 98: 791–5.

Gray

. Basement membrane zone injury in vocal nodules. In: Gauffin

Hammarberg

, eds. Vocal Fold Physiology Conference. San Diego, Calif: Singular Press, 1991: 21–7.

Gray

Hirano

Sato

. Molecular and cellular structure of vocal fold tissue. In: Gauffin

Hammarberg

, eds. Vocal fold physiology. San Diego, Calif: Singular Press, 1992: 1–35.

Lumpkin

Bennett

Bishop

. Postsurgical follow-up study of patients with severe polypoid degeneration. Laryngoscope 1990; 100: 399–402.

10.

Lumpkin

SMM

Bishop

Bennett

. Comparison of surgical techniques in the treatment of laryngeal polypoid degeneration. Ann Otol Rhinol Laryngol 1987; 96: 254–7.

11.

Monday

Comut

Bouchayer

Roch

. Epidermoid cysts of the vocal cords. Ann Otol Rhinol Laryngol 1983; 92: 124–7.

12.

Monday

Cornut

Bouchayer

Roch

Loire

. Diagnosis and treatment of intracordal cysts. J Otolaryngol 1981; 10: 363–70.

13.

Bouchayer

Cornut

. Microsurgery for benign vocal fold lesions. Ear Nose Throat J 1988; 67: 446–64.

14.

Ford

Bless

. Phonosurgery, assessment and surgical management of voice disorders. New York, NY: Raven Press, 1991.