The authors report their experience in the use of surgery for the treatment of dysphonia plica ventricularis, the vocal disorder which results when enlargement of the ventricular folds impairs true vocal cord apposition. Diagnosis was made by means of microlaryngoscopy under local anesthesia applying neuroleptic drugs. Surgery was reserved for those patients whose mucosal hypertrophy did not respond to medications, psychotherapy and persistent speech exercises. The surgical technique employed consisted of grasping the central portion of the ventricular fold, pulling it medially, and excising the triangular portion of mucosa thus exposed. The underlying vocal cord was used as a point of reference for the excision. The raw surface was observed to reepithelialize rapidly. Cortisone inhalations were administered postoperatively in order to decrease the chance of scar formation. The 25 patients treated in this manner have done well during the one to four year follow-up period.
Vocal cord biopsy under local anesthesia, with flexible bronchoscope as an outpatient procedure, by “inside-out” technique
