Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-23T13:00:10.377Z Has data issue: false hasContentIssue false

Vocal outcomes following subepithelial infiltration technique in microflap surgery: a review of 30 cases

Published online by Cambridge University Press:  20 April 2007

N Nerurkar*
Affiliation:
Department of ENT, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.
N Narkar
Affiliation:
Department of ENT, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.
A Joshi
Affiliation:
Department of ENT, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.
K Kalel
Affiliation:
Department of ENT, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.
R Bradoo
Affiliation:
Department of ENT, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.
*
Address for correspondence: Dr Nupur Kapoor Nerurkar, D/603 Simla House, Napean Sea Road, Mumbai 400 026, India. Fax: 91 22 24076100 E-mail: nupurkapoor@yahoo.com

Abstract

Understanding of the anatomy and physiology of the vocal folds, availability of better diagnostic tools and precise instruments has spurred the development of newer techniques for the management of benign lesions arising in the vocal folds. As the propensity of the superficial lamina propria to regenerate is minimal, it is of paramount importance to maximally preserve it. Microflap surgery of the vocal folds is based on this principle.

There exists a dichotomy in opinion regarding the role of subepithelial infiltration in microflap surgery; the disadvantages cited being possible confusion of the surgical plane following infiltration and hydrodissection of the normal basement membrane from the superficial layer of the lamina propria. A prospective study was therefore carried out in 30 cases of benign glottic lesions and microflap surgery was performed with and without infiltration in similar pathologic lesions. The vocal outcomes i.e. fundamental frequency, jitter, shimmer and maximum phonation time were audited. The advantages of this technique with a review of the literature are discussed.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Gray, SD, Hammond, E, Hanson, DF. Benign pathologic responses of the larynx. Ann Otol Rhinol Laryngol 1995;104:1318CrossRefGoogle ScholarPubMed
2Kuhn, J, Toohill, RJ, Ulualp, SO. Pharyngeal acid reflux events in patients with vocal fold nodules. Laryngoscope 1998;108:1146–9CrossRefGoogle Scholar
3Dikkers, FG, Nikkels, PGJ. Benign lesions of the vocal folds: Histopathology and phonotrauma. Ann Otol Rhinol Laryngol 1996;104:698703CrossRefGoogle Scholar
4Pressman, J, Dowdy, A, Libby, R, Fields, M. Further studies upon the submucosal compartments and lymphatics of the larynx by injection of dyes and radioisotopes. Ann Otol Rhinol Laryngol 1956;65:963–80CrossRefGoogle ScholarPubMed
5Pressman, J, Bertz, MB, Monell, C. Anatomic studies related to the dissemination of cancer of the larynx. Trans Am Acad Ophthalmol Otolaryngol 1960;64:628–38Google Scholar
6Welsh, LW, Welsh, JJ, Rizzo, TA JrLaryngeal spaces and lymphatics: Current anatomic concepts. Ann Otol Rhinol Laryngol 1983;92(suppl 105):1931Google Scholar
7Hirano, M, Yoshida, T, Hirade, Y, Sanada, T. Improved surgical technique for epidermoid cyst of the vocal fold. Ann Otol Rhinol Laryngol 1989;98:791–5CrossRefGoogle ScholarPubMed
8Zeitels, SM, Vaughan, CW. A submucosal vocal fold infusion needle. Otolaryngol Head Neck Surg 1991;105:478–9Google Scholar