Microsurgical pressing excision technique for vocal nodules and simple epithelial hyperplasia of the vocal fold

2004 ◽  
Vol 118 (3) ◽  
pp. 223-227 ◽  
Author(s):  
Ka-Wo Lee ◽  
Wen-Rei Kuo ◽  
Kuen-Yao Ho ◽  
Feng-Yu Chiang
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Epithelial Hyperplasia ◽  
Treatment Results ◽  
Microsurgical Technique ◽  
Precise Method ◽  
Potential Risks ◽  
Vocal Nodules ◽  
Microlaryngeal Surgery ◽  
Epithelial Lesions

Precise bimanual microsurgical excision of sessile, thin benign epithelial lesions of the vocal folds can be difficult. During microlaryngeal surgery, the potential risks of over-excision and under-excision are of major concern. We introduce a microsurgical technique using horizontally-opening curved microforceps and microscissors, instead of the conventional vertically-opening microinstruments, to remove vocal nodules and simple epithelial hyperplasia. The treatment results were satisfactory, with 208 (90.8 per cent) of patients retaining a satisfactory/normal (G0) voice. No patient had a worsened voice after the procedure. This microsurgical pressing excision technique is an alternative precise method for microlaryngosurgery.

Indirect Microsurgery of the Vocal Folds - Videostroboscopy vs. Microstroboscopy

1993 ◽  
Vol 72 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Zoran Milutinović
Keyword(s):  
Laser Surgery ◽  
Vocal Fold ◽  
Vocal Folds ◽  
Surgical Approaches ◽  
Surgical Trauma ◽  
Benign Lesions ◽  
Functional Control ◽  
Microlaryngeal Surgery ◽  
Surgical Manipulation ◽  
Vocal Fold Surgery

In spite of the great significance of direct microlaryngeal surgery (DML), the inadequacies of this technique are evident. In order to avoid surgical trauma and introduce functional control during surgery, indirect microstroboscopic (IMS) and indirect videostroboscopic surgery (IVS) of the vocal folds are advocated. Both of these meet most criteria for surgical work in this field. The aim of this work was to make a comparative study of these techniques. The study is based on 603 operations conducted for benign lesions of the vocal folds. We are of the opinion that indirect vocal fold surgery for small benign lesions has significant advantages when compared with the conventional microlaryngoscopy, including laser surgery, which was proven elsewhere. When comparing these two indirect surgical approaches, the principal advantages of IVS surgery over the IMS method are easier surgical manipulation and better view. With respect to other areas of comparison, these techniques are quite similar. As complementary methods to conventional microlaryngoscopy, we believe that both IVS and IMS surgery should be used in practice.

Finite Element Modeling of Vocal Fold Vibration in Normal Phonation and Hyperfunctional Dysphonia: Implications for the Pathogenesis of Vocal Nodules

1998 ◽  
Vol 107 (7) ◽  
pp. 603-610 ◽  
Author(s):  
Jack J. Jiang ◽  
Carlos E. Diaz ◽  
David G. Hanson
Keyword(s):  
Finite Element ◽  
Finite Element Modeling ◽  
Mechanical Stress ◽  
Vocal Fold ◽  
Vocal Folds ◽  
Element Modeling ◽  
Modeling Technology ◽  
Vocal Fold Vibration ◽  
Vocal Nodules ◽  
High Mechanical Stress

A computer model of the vocal fold was developed using finite element modeling technology for studying mechanical stress distribution over vibrating vocal fold tissue. In a simulated normal phonation mode, mechanical stress was found to be lowest at the midpoint of the vocal fold and highest at tendon attachments. However, when other modes predominated, high mechanical stress could occur at the midpoint of the vocal folds. When a vocal fold mass was modeled, high shearing stress occurred at the base of the modeled vocal fold mass, suggesting that the presence of a vocal nodule or polyp is associated with high mechanical stress at the margins of the mass. This finding supports a hypothesis that mechanical intraepithelial stress plays an important role in the development of vocal nodules, polyps, and other lesions that are usually ascribed to hyperfunctional dysphonia.

scholarly journals Does Voice Therapy Cure All Vocal Fold Nodules?

2014 ◽  
Vol 4 (2) ◽  
pp. 55-59 ◽  
Author(s):  
Baisakhi Bakat ◽  
Arunima Roy ◽  
Amitabha Roychoudhury ◽  
Barin Kumar Raychaudhuri
Keyword(s):  
Vocal Fold ◽  
Tertiary Care ◽  
Vocal Folds ◽  
Voice Therapy ◽  
Care Hospital ◽  
Laryngeal Surgery ◽  
Voice Outcome ◽  
Vocal Nodules ◽  
A Prospective Study ◽  
Vocal Fold Nodules

ABSTRACT Introduction Vocal nodules are known to be one of the most common benign lesions, commonly situated at the junction of anterior one third and posterior two third of vocal folds. Voice therapy is considered to be the gold standard of treatment of vocal fold nodule. Objectives To determine the efficacy of voice therapy in the treatment of vocal fold nodules and to identify any possible reason for failure to voice therapy in managing vocal fold nodules. Materials and methods A prospective study, conducted over a period of 6 months. Eighteen adult patients diagnosed with vocal fold nodules at a tertiary care hospital were subjected to 6 weeks of voice therapy. Pre and post therapy subjective (Voice Handicap Index-10) and objective (Rigid fiber optic laryngoscopy) evaluation was done. Patients with no improvement after 6 weeks of voice therapy underwent micro laryngeal surgery. All patients were followed up at 3 months and 6 months. Results In majority of patients, objective and subjective voice outcome parameters were significantly improved after voice therapy. Although a few cases showed no significant improvement after therapy, they recovered completely after microlaryngoscopic surgery. It was found that patients who required surgery even after voice therapy had hard nodules. How to cite this article Bakat B, Gupta A, Roy A, Roychoudhury A, Raychaudhuri BK. Does Voice Therapy Cure All Vocal Fold Nodules? Int J Phonosurg Laryngol 2014;4(2):55-59.

scholarly journals Endoscopic Findings of Early Stage Vocal Fold Cancer

1995 ◽  
Vol 1 (4) ◽  
pp. 185-194
Author(s):  
Peter Kitzing
Keyword(s):  
Vocal Fold ◽  
Early Stage ◽  
Precancerous Lesions ◽  
Vocal Folds ◽  
Histologic Diagnosis ◽  
High Tendency ◽  
Epithelial Lesions ◽  
Invasive Carcinomas

To describe early cancerous and precancerous lesions of the laryngeal vocal folds as well as of the most common differential diagnoses, based on a series of microlaryngoscopic photographs. Some introductory remarks about terminology and the classification of epithelial lesions of the vocal folds are included. The paper ends with some comments as to the management of epithelial thickenings (or leukoplakias) of the vocal folds. Malignancy should be suspected as long as it has not been ruled out by histologic diagnosis on adequate biopsies, which is the only way to correctly evaluate the character of such lesions. Precancerous lesions should be controlled by regular follow up examinations as carefully as invasive carcinomas (posttreatment), because there is a high tendency for recurrences or for later development of malignancy in these cases.

Use of Co2 Laser versus conventional microlaryngeal surgery in treatment of vocal fold benign lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hesham El-Halaby ◽  
Marwa M El-Begermy ◽  
Mina Zakaria Hakim
Keyword(s):  
Lamina Propria ◽  
Co2 Laser ◽  
Vocal Fold ◽  
Meta Analysis ◽  
Vocal Folds ◽  
Superficial Layer ◽  
Sufficient Evidence ◽  
Benign Lesions ◽  
Benign Vocal Fold Lesions ◽  
Microlaryngeal Surgery

Abstract Background Benign superficial lesions of vocal fold (nodule, polyp, cyst and Reinke's edema) arise from the epithelium and the lamina propria. Vocal abuse and misuse presumably lead to excessive mechanical stress and trauma in the membranous portion of vocal fold, resulting in wound formation. Wound healing leads to remodeling of the superficial layer of the lamina propria. This tissue remodeling leads to formation of benign vocal fold lesions. These lesions are classically treated by conventional microsurgery and recently by CO2 laser. The use of the CO2 laser for the surgical treatment of Minor Associated Pathological Lesions (MAPL's) is still controversial. Some preferred cold instruments, whereas others appreciate CO2 laser as a novel alternative to conventional microsurgery for benign vocal fold lesions. To summarize the reviewed literature the issue of CO2 laser versus cold instruments is still controversial and the stage is open for more studies. Aim The aim of this study is to investigate the effect of Co2 Laser versus cold instruments in the treatment of benign lesions of the vocal folds regarding voice outcome & vocal fold function. Methodology A meta-analysis study is done to assess the use of Co2 Laser versus conventional microlaryngeal surgery in treatment of vocal fold benign lesions. Results This study does not reveal any detectable differences in clinical outcomes in patients with nodules, polyps and cysts who underwent excision via CO2 laser or cold instruments. Conclusion There is no sufficient evidence to determine if conventional surgery or CO2 assisted surgery is better.

Mucosal Suture for the Treatment of Postoperative Vocal Fold Adhesion Following the Microlaryngeal Surgery for Papilloma

2003 ◽  
Vol 54 (3) ◽  
pp. 214-218
Author(s):  
Kentaro Sato ◽  
Makito Okamoto ◽  
Koichiro Nishiyama ◽  
Masatoshi Hirayama ◽  
Hajime Hirose
Keyword(s):  
Vocal Fold ◽  
Microlaryngeal Surgery

scholarly journals Concurrent YAP/TAZ and SMAD signaling mediate vocal fold fibrosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ryosuke Nakamura ◽  
Nao Hiwatashi ◽  
Renjie Bing ◽  
Carina P. Doyle ◽  
Ryan C. Branski
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Nuclear Accumulation ◽  
Smad Pathway ◽  
Surgical Interventions ◽  
Smad Signaling ◽  
Iatrogenic Damage ◽  
Tgf Β1

AbstractVocal fold (VF) fibrosis is a major cause of intractable voice-related disability and reduced quality of life. Excision of fibrotic regions is suboptimal and associated with scar recurrence and/or further iatrogenic damage. Non-surgical interventions are limited, putatively related to limited insight regarding biochemical events underlying fibrosis, and downstream, the lack of therapeutic targets. YAP/TAZ integrates diverse cell signaling events and interacts with signaling pathways related to fibrosis, including the TGF-β/SMAD pathway. We investigated the expression of YAP/TAZ following vocal fold injury in vivo as well as the effects of TGF-β1 on YAP/TAZ activity in human vocal fold fibroblasts, fibroblast-myofibroblast transition, and TGF-β/SMAD signaling. Iatrogenic injury increased nuclear localization of YAP and TAZ in fibrotic rat vocal folds. In vitro, TGF-β1 activated YAP and TAZ in human VF fibroblasts, and inhibition of YAP/TAZ reversed TGF-β1-stimulated fibroplastic gene upregulation. Additionally, TGF-β1 induced localization of YAP and TAZ in close proximity to SMAD2/3, and nuclear accumulation of SMAD2/3 was inhibited by a YAP/TAZ inhibitor. Collectively, YAP and TAZ were synergistically activated with the TGF-β/SMAD pathway, and likely essential for the fibroplastic phenotypic shift in VF fibroblasts. Based on these data, YAP/TAZ may evolve as an attractive therapeutic target for VF fibrosis.

High-Speed Imaging to Study an Auto-Oscillating Vocal Fold Replica for Different Initial Conditions

2017 ◽  
Vol 09 (05) ◽  
pp. 1750064 ◽  
Author(s):  
A. Van Hirtum ◽  
X. Pelorson
Keyword(s):  
Vocal Fold ◽  
High Speed ◽  
Initial Conditions ◽  
Vocal Folds ◽  
High Speed Imaging ◽  
Human Voice ◽  
Manual Intervention ◽  
Geometrical Features ◽  
Upstream Pressure

Experiments on mechanical deformable vocal folds replicas are important in physical studies of human voice production to understand the underlying fluid–structure interaction. At current date, most experiments are performed for constant initial conditions with respect to structural as well as geometrical features. Varying those conditions requires manual intervention, which might affect reproducibility and hence the quality of experimental results. In this work, a setup is described which allows setting elastic and geometrical initial conditions in an automated way for a deformable vocal fold replica. High-speed imaging is integrated in the setup in order to decorrelate elastic and geometrical features. This way, reproducible, accurate and systematic measurements can be performed for prescribed initial conditions of glottal area, mean upstream pressure and vocal fold elasticity. Moreover, quantification of geometrical features during auto-oscillation is shown to contribute to the experimental characterization and understanding.

scholarly journals Plutonium-induced Proliferative Lesions and Pulmonary Epithelial Neoplasms in the Rat: Immunohistochemical and Ultrastructural Evidence for Their Origin from Type II Pneumocytes

1994 ◽  
Vol 31 (3) ◽  
pp. 366-374 ◽  
Author(s):  
R. A. Herbert ◽  
B. S. Stegelmeier ◽  
N. A. Gillett ◽  
A. H. Rebar ◽  
W. W. Carlton ◽  
...  
Keyword(s):  
Clara Cell ◽  
Normal Lung ◽  
Type Ii ◽  
Epithelial Hyperplasia ◽  
Cell Antigen ◽  
Alveolar Epithelial ◽  
Type Ii Pneumocytes ◽  
Epithelial Neoplasms ◽  
Epithelial Lesions ◽  
Surfactant Apoprotein

Immunohistochemistry and transmission electron microscopy were used to clarify the cellular origin for plutonium-239-induced pulmonary proliferative (preneoplastic) epithelial lesions and epithelial neoplasms in F344 rats. Examples of each histologic type of proliferative lesion and neoplasm were stained by the avidin-biotin complex immunoperoxidase method using antibodies to rat surfactant apoprotein and Clara cell antigen. Rat surfactant apoprotein immunostaining was detected in type II pneumocytes in sections of normal lung, in the cells of the proliferative lesions classified histologically as alveolar epithelial hyperplasia (51) and mixed foci (alveolar epithelial hyperplasia with fibrosis) (30), and in adenomas (2), adenocarcinomas (3), and adenosquamous carcinomas (2). With the exception of one adenosquamous carcinoma, Clara cell antigen immunostaining was not detected in any of the pulmonary lesions but was detected in nonciliated cuboidal epithelial (Clara) cells in normal bronchioles. The epithelial cells of the proliferative lesions and neoplasms had ultrastructural features consistent with type II pneumocytes, i.e., the presence of cytoplasmic lamellar and multivesicular bodies. The results of these studies indicate that the majority of plutonium-induced proliferative epithelial lesions and neoplasms in the rat originate from alveolar type II pneumocytes.

Laryngeal Framework Surgery in the Management of Spasmodic Dysphonia

1989 ◽  
Vol 98 (1) ◽  
pp. 52-54 ◽  
Author(s):  
Harvey M. Tucker
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Long Term Results ◽  
Spasmodic Dysphonia ◽  
Management Problem ◽  
Cure Rate ◽  
Adductor Spasmodic Dysphonia ◽  
Laryngeal Framework Surgery ◽  
Selective Lysis

Spasmodic dysphonia continues to be a management problem for otolaryngologists. Selective lysis of the recurrent laryngeal nerve has been useful in the management of this disease. Reported long-term results, however, reveal that spasm recurs in approximately 40% to 50% of initially successful patients in spite of persistence of the unilateral vocal fold paralysis. Although some of these failures can be recaptured with subsequent laser surgery, the overall “cure” rate does not exceed 70%, even in the best hands. The contributions of Isshiki, LeJeune, and Tucker have demonstrated that tension in the vocal folds can be adjusted by laryngeal framework surgery. Experience with 16 patients suffering from adductor spasmodic dysphonia suggests that laryngeal framework surgery is useful in the management of this disorder.

Sign in / Sign up

Export Citation Format

Share Document