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

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.

scholarly journals Head and Neck Myxoma Presenting as Isolated Laryngeal Polyp

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Smriti Panda ◽  
Rajeev Kumar ◽  
Vikram Raj Gopinath ◽  
Prem Sagar
Keyword(s):  
Differential Diagnosis ◽  
Head And Neck ◽  
Vocal Cord ◽  
Vocal Fold ◽  
Web Of Science ◽  
Anecdotal Evidence ◽  
Local Infiltration ◽  
Vocal Cord Polyp ◽  
History Of ◽  
Microlaryngeal Surgery

Myxoma is a benign tumour with a propensity for local infiltration and recurrence. Laryngeal myxoma presents as a submucosal polyp. Being an uncommon tumour and mimicking vocal cord polyp, only anecdotal evidence is available in the literature. The literature was reviewed from 1986 onwards using the keywords “myxoma” and “larynx.” The databases used were PubMed, Google Scholar, Scopus, and Web of Science. Along with this, we also report our case of vocal fold myxoma. We found a total of 19 studies reporting laryngeal myxoma. Laryngeal myxoma typically affects males in the 6th decade with a history of smoking. Unlike myxomas originating outside the larynx, recurrence is not widely described, and microlaryngeal surgery will usually suffice. Laryngeal myxomas should definitely be kept in the list of differential diagnosis when dealing with a benign-looking vocal fold lesion.

scholarly journals Outcome of Microlaryngeal Surgery for Vocal Fold Polyp on Quality of Voice

2017 ◽  
Vol 7 (1) ◽  
pp. 13-15
Author(s):  
Jayakumar R Menon ◽  
Manju E Issac ◽  
HS Sabari Nath ◽  
Ragitha Binukrishnan ◽  
Akhila Sebastian
Keyword(s):  
Vocal Fold ◽  
P Value ◽  
Vocal Cord Polyp ◽  
Number Of Patients ◽  
Quasi Experimental ◽  
The Mean ◽  
Quality Of Voice ◽  
Microlaryngeal Surgery ◽  
Self Reporting Questionnaire

ABSTRACT Aim To study the outcome of microlaryngeal surgery for vocal fold polyp on quality of voice with voice handicap index-10 (VHI-10). Objective Microlaryngeal surgery for vocal fold polyp will improve the quality of voice. Materials and methods This is a nonrandomized prospective study with a quasi-experimental design. A total of 36 patients presenting with vocal cord polyp and who underwent a microlaryngeal surgery for the same from March 2016 to August 2016 were included in the study. All the patients were given a self-reporting questionnaire consisting of 10 questions — VHI-10 — and asked to score it. The same questionnaire was given 6 weeks postmicrolaryngeal surgery to these patients and both scores were compared. Results The mean age of the study population was 44.67 ± 0.34 with the maximum number of patients in the age group 31 to 50. Out of the 36 patients, 27 were males and 9 females. A total of 22 (61%) patients had right-sided polyp and 14 (39%) had left-sided polyp. The majority of the patients were voice professionals, with the maximum number being that of teachers. The mean preoperative and postoperative VHI-10 was 30.36 ± 6.42 and 1.11 ± 1.76 respectively. The reduction in preoperative and postoperative scores gave a p-value of <0.05 at a confidence interval of 95%. How to cite this article Nath HSS, Menon JR, Issac ME, Binukrishnan R, Sebastian A. Outcome of Microlaryngeal Surgery for Vocal Fold Polyp on Quality of Voice. Int J Phonosurg Laryngol 2017;7(1):13-15.

scholarly journals Assessment of pre and postoperative voice quality in cases of vocal fold polyp

2020 ◽  
Vol 6 (2) ◽  
pp. 352
Author(s):  
Sachana Prasad ◽  
Ranjan Raychowdhury ◽  
Amitabha Roychoudhury
Keyword(s):  
Vocal Fold ◽  
Vocal Communication ◽  
Voice Quality ◽  
Maximum Phonation Time ◽  
Flap Technique ◽  
Wide Range ◽  
Significant Impairment ◽  
Benign Tumours ◽  
Microlaryngeal Surgery

<p class="abstract"><strong>Background:</strong> Benign vocal fold lesions comprise of a wide range of conditions resulting from vocal misuse or abuse (vocal nodules, polyps, cysts etc.), acute and chronic inflammatory changes, congenital vocal fold anomalies, vocal fold trauma and benign tumours. It results in significant impairment of vocal communication with major psychosocial impact.</p><p class="abstract"><strong>Methods:</strong> The<strong> </strong>prospective<strong> </strong>study was conducted in Department of Otolaryngology, Vivekananda Institute of Medical Sciences, Kolkata from January 2016 to January 2018. All forty patients diagnosed with vocal fold polyp underwent phonomicrosurgery using micro-flap technique followed by voice therapy. Detailed pre-operative and post-operative (3 weeks, 6 weeks, 12 weeks follow up) voice assessment including fibre optic laryngoscopy and laryngovideo-stroboscopic findings were recorded.  </p><p class="abstract"><strong>Results:</strong> Voice quality of the 40 patients with vocal fold polyps who underwent cold steel phonomicrosurgery had a statistically significant improvement at each follow up visit (3 weeks, 6 weeks and 12 weeks) as assessed by the subjective variables of voice handicap index score, visual analogue scale score and grade, roughness, breathiness, asthenia, strain score and objective variables of jitter, shimmer, harmonic-to-noise ratio, maximum phonation time and fibreoptic laryngoscopy and videolaryngostroboscopic findings. Fundamental frequency in females had statistically improved results but in males, though there was an improvement, the values were not statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> Cold steel microlaryngeal surgery using micro-flap technique offers excellent results in patients with vocal fold polyps. Perceptual, aerodynamic, acoustic, self-analysis and videolaryngostroboscopic parameters together allow multidimensional assessment of voice characteristics.</p>

scholarly journals Pleomorphic Undifferentiated Sarcoma (Malignant Fibrous Histiocytoma) of True Vocal Fold: A Rare Laryngeal Malignancy

2020 ◽  
Vol 28 (1) ◽  
pp. 84-87
Author(s):  
Rohit Bhardwaj ◽  
Ankur Gupta ◽  
Sabarirajan Ponnusamy ◽  
Karthika Nathan
Keyword(s):  
Case Report ◽  
Head And Neck ◽  
Malignant Fibrous Histiocytoma ◽  
Vocal Fold ◽  
Fibrous Histiocytoma ◽  
Neck Region ◽  
Detailed Examination ◽  
Complete Excision ◽  
Undifferentiated Sarcoma ◽  
Microlaryngeal Surgery

Introduction Pleomorphic undifferentiated sarcoma also known as Malignant fibrous histiocytoma, is a malignanat tumour which commonly involves upper and lower extremities and the retroperitoneum. Only a few sporadic MFHs located in the head and neck have been reported in the literature. Rarely the tumor can involve larynx. Complete excision of the tumor is the standard treatment but post-operative chemotherapy and / or radiotherapy is also recommended in selected cases. Case Report We present a rare case report of pleomorphic undifferentiated sarcoma also known as malignanat fibrous histiocytoma of true vocal fold in a 65 years old male patient. The patient presented to us with complaints of change in voice for past 3 months. He also reported about his smoking habits for past 35 years. On detailed examination of head and neck region no palpable lymph nodes were detected. Oral and nasal cavity examination also did not reveal any pathology. On endoscopic laryngeal assessment a polypoidal mass was seen arising from posterior half of anterior third of left true vocal fold. The vocal fold mobility was found normal.We completely excised the tumor by microlaryngeal surgery. The histopathological and immunohistochemical examination of the excised tissue identified the tumor being a pleomorphic undifferentiated sarcoma which was positive for Vimentin, EMA and negative for CK, p63. Patient did not receive radiotherapy/ chemotherepy in postoperative period. Patient has been under follow-up for past 6 months and is disease free as of now. Discussion Mesenchymal malignancies of larynx are rare entities. Pleomorphic undifferentiated sarcoma also known as malignanat fibrous histiocytoma is one of such malignancy. The treatment consists of complete excision of the lesion. The need of post-operative radiotherapy and/ chemotherapy depends on the extent of disease.

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.

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.

The Art and Craft of Phonomicrosurgery in Grammy Award–Winning Elite Performers

2019 ◽  
Vol 128 (3_suppl) ◽  
pp. 7S-24S ◽  
Author(s):  
Steven M. Zeitels
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Significant Loss ◽  
Human Voice ◽  
Voice Science ◽  
Award Winning ◽  
Precision Management ◽  
Key Issues ◽  
Microlaryngeal Surgery

Background: Since the renowned opera maestro Manuel Garcia presented “Observations on the Human Voice” using mirror laryngoscopy in 1855, there has been an inextricable link between performing vocalists and laryngologists. Today, specialized laryngeal surgeons continue the tradition of integrating medical and surgical management of performers with those skilled in vocal arts, voice science, and voice therapy. With advances in surgical instrumentation and techniques, increasing opportunities have evolved to surgically restore lost performing voices. However, it is especially challenging because of a range of factors, including the need for optimal technical precision, management of expectations, complexity of informed consent, public visibility of these patients, and the economics related to the success and failure of surgery. A number of these key issues apply to phonomicrosurgical procedures in nonsingers as well. Consequently, reviewing the art and craft of phonomicrosurgery in elite performers provides valuable insights into the optimal management of any patient. Methods: A retrospective review was done of microlaryngeal procedures for the past 20 years, and 18 elite performers were identified who were Grammy Award winners. Microsurgical methods for different lesions are illustrated. Composite analyses of the group along with their associated pathology was done to provide insights into key issues. Results: The 18 patients in this cohort have won 80 Grammy Awards, which were garnered from 242 nominations. All 18 had substantial deterioration in voice quality and could retain more than 1 pathology. Significant loss of superficial lamina propria (SLP) pliability was present in 15 of 18, varices and/or ectasias leading to vocal hemorrhage in 6, vocal polyps in 9, fibrovascular nodules in 6, arytenoid granuloma in 1, sulcus from prior microlaryngeal surgery leading to vocal fold SLP scarring in 4, sulcus from long-term phonotrauma leading to vocal fold SLP scarring in 4, benign cyst in 1, precancerous dysplasia in 2, and invasive carcinoma in 2. Subsequent to phonomicrosurgery, all reported improvement in their performance. Conclusions: Laryngologists and laryngeal surgeons have shouldered a burden of responsibility for elite performing vocalists since the origin of our specialty. Most lesions and diagnoses that are encountered result from phonotrauma. Optimizing singers’ care provides surgeons with extremely complex technical, emotional, social, and financial challenges. Focused analysis of managing elite performing vocalists effectively integrates a range of essential issues, which provide key insights to assist clinicians treating nonperforming patients requiring phonomicrosurgery.

scholarly journals Correlation between Rigid Laryngoscopy and Histopathology of Laryngeal Lesions at Our Voice Clinic

2011 ◽  
Vol 1 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Sunil Garg
Keyword(s):  
Clinical Diagnosis ◽  
Vocal Fold ◽  
Malignant Lesion ◽  
Voice Disorders ◽  
Laryngeal Surgery ◽  
Diagnostic Potential ◽  
Technological Advances ◽  
Laryngeal Lesions ◽  
One Year ◽  
Microlaryngeal Surgery

ABSTRACT Introduction In today's world of rapid technological advances, the medical field is developing at a rapid speed. Various sophisticated tools are available for the diagnostic work-up of patients with voice disorders. These are stroboscopy, optical coherence tomography (OCT), contact endoscopy and laryngeal USG, which gives sophisticated details of the larynx. However, at present most of these modalities are expensive and available only at few research centers. Rigid laryngoscopy is a noninvasive, easily available and fairly accurate diagnostic tool in patients with voice disorders. Aims and objectives The aim of our study was to assess the diagnostic potential of rigid laryngoscopy in different laryngeal lesions and its correlation with histopathology. This is a one year retrospective study at our voice clinic at Bombay Hospital, Mumbai. Patients and methods We examined 720 patients at our voice clinic from January 2008 to December 2008. Microlaryngeal surgery was performed on 59 of these. The clinical diagnosis was made after detailed history taking and clinical examination by a 70 degree Hopkins rod telescope. Results In our study, clinical diagnosis was 100% accurate in vocal fold subepithelial cyst, vocal fold nodules, laryngeal papilloma and contact granuloma. The clinical diagnosis had a reliability of 30% for Vocal fold polyps, 50% for leukoplakia, and 66% for malignant lesion. In suspected laryngeal polyps, leukoplakia and malignancy, our study indicates that we need to excise the lesion surgically and prove the histopathology. Conclusion Every tissue removed during laryngeal surgery should be sent for histopathology. Rigid Laryngoscopy is a safe and accurate tool to diagnose nodules and cysts.

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