Analysis of Surgical Recurrence after Larynx Microsurgery for Benign Lesions

Introduction The study of larynx lesions is of great importance. More than 50% of people with vocal complaints have benign vocal fold alterations and some require surgery. Objective To determine which factors are related to surgical recurrence of benign laryngeal lesions and to determine which videolaryngoscopic diagnoses are related to the risk or protection of surgical relapses over time. Methods Observational, analytical, cross-sectional study with retrospective data collection of 1,383 surgeries in 1,301 patients. Results The mean age at the first surgery was 39.2 years old. The predominant gender was female (65.6%).There were 396 cases of polyps (25.34%), 349 cases of cysts (22.33%), 261 cases of Reinke edema (16.7%), 175 cases of nodules (11.2%), 153 cases of minor structural alterations (MSAs) (9.79%), 94 cases of leukoplakia (6.01%), 77 cases of granulomas (4.93%) and 58 cases of pseudocysts (3.71%). The age presented statistical significance with the risk of surgical relapses (p = 0.016). Male gender was associated with the greatest chance of relapse.Diagnosis of granuloma (p < 0.001) and of leukoplakia (p < 0.001) were associated with a higher risk of surgical recurrence. Cyst diagnosis was associated with protection (p = 0.015) in relation to the chance of further surgeries. Patients with associated lesions, bilaterals or voice professionals did not present a statistically significant association with surgical recurrence. Conclusion Age and gender are statistically related to the increase of surgical relapses. Leukoplakia and granuloma are associated with increased surgical relapses. Patients submitted to cyst microsurgery appear to be protected against surgical recurrence.

Profile of Laryngeal Microsurgeries in Patients Over 60 Years Old

Introduction The increase in life expectancy is an incentive to the development of researches with the elderly population aiming at actions that may ensure healthy and active aging. Objective To analyze the profile of laryngeal microsurgery performed in patients > 60 years old. Methods A retrospective observational study, with a cross-sectional design. A retrospective analysis of the medical records of elderly patients submitted to laryngeal microsurgery was performed at a private hospital in Curitiba, state of Paraná, Brazil, between January 2004 and December 2016. Were included all of the patients > 60 years old that underwent laryngeal microsurgery during this period. Results During the studied period, 213 laryngeal microsurgeries were performed in 181 patients > 60 years old. There was a preponderance of male patients. The mean age was 67.6 years old. Squamous cell carcinoma (SCC) was the most prevalent disorder (26%), followed by Reinke edema (20%), papillomatosis (14%), polyps (11%), leukoplakia (8%), minor structural alterations (8%), associated lesions (9%), and others (4%). Men presented a higher probability of SCC diagnosis, regardless of the age group, while Reinke edema was more frequently observed in women. A directly proportional relation between the frequency of laryngeal cancer and age increase was also observed. No significant differences were observed in professional voice users. Conclusion Further researches are required to properly comprehend the factors associated with laryngeal lesions and determine prevention and treatment approaches.

TREATMENT RESULTS OF BENIGN VOCAL CORD TUMORS BY ENDOSCOPIC SURGERY WITH SUSPENSION LARYNGOSCOPY

Backgrounds: Benign vocal cord tumors are common diseases in Vietnam and in all over the world. Objectives: To evaluate treatment results of benign vocal cord tumors by endoscopic surgery with suspension laryngoscopy. Material and Methods: A total of 105 patients with benign vocal cord tumors treated by suspension endoscopic surgery, conducted by a prospective descriptive study, with clinical intervention. Results: 105 patients included 59% female, 41% male. Mean age is 41.68 ± 13.81. The pathology of tumors were nodules (42.95%), cysts (28.6%), polyp (19.0%), Reinke edema (3.8%) and papiloma (5.7%). The mean of time of surgery was 25.23± 5.34 minutes. Once month post-operative, all patients recovered their voice (89.5%). Local complications wwre: oral membrance torn, having trouble with tongue sensory (18.1%). There were no case of servere complication. Conclusion: Laryngeal endoscopic surgery is the modern, safe, conventient technique, remove all of pathologic tisses and no effect nomal tissues. Result of surgery for benign laryngeal tumors was good. All patients satisfied with their outcome (92.4%) of voice rehabilitation. Key words: Rigid Endoscopy associated with Suspension Laryngoscopy, Benign Laryngeal Lesions

Subjective Voice Assessment after Endoscopic Surgery for an Obstructive Reinke Edema Using Voice Handicap Index

Voice disorders exert a dramatic influence on patients’ quality of life (QOL). The physical, functional, and emotional impact can be accurately assessed using the conventional questionnaire of “voice handicap index” (VHI) or its shorter version, the VHI-10. We evaluated the VHI scores of patients suffering from obstructive Reinke’s edema, a benign laryngeal disorder, before and after endoscopic treatment. Comparison of pre- and postoperative VHI scores showed the treatment efficacy. The scores achieved were similar to asymptomatic individuals (control group), thus improving their quality of life. Furthermore, both VHI and VHI-10 tests yielded similar scores. We suggest routine systematic incorporation of the VHI-10 test for pre- and postoperative routine evaluation of patients with Reinke’s edema. The results are faster and reliable.