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Transoral laser surgery for anterior commissure involvement: a study in canines
Guangbin Sun1, Haihong Tang, Alicia J Sprecher
1Department of Otolaryngology, Gongli Hospital of Pudong New District, 219 Miaopu Road, Pudong New Area, Shanghai 200135, PR China. sgb223@hotmail.com
Objective:
To present laser surgery techniques to address anterior commissure involvement and evaluate recovery.
Methods:
Twelve canines were divided into three groups. In group A the right ventricular band and vocal fold, the anterior third of the left vocal fold, and anterior commissure were cauterized. In group B cauterization was extended to the thyroid cartilage and a 5 mm x 5 mm area of the anterior commissural to half the cartilage thickness. In group C the 5 mm x 5 mm window was extended through the thyroid cartilage. Surgical lesions were observed after surgery and at 1 and 4 weeks post-surgery.
Results:
Post-operative gross examination confirmed target scopes. One week after surgery, the lesions in group A were completely covered by neo-mucosa, while group B and C wounds were only partially covered. After 4 weeks, a laryngeal web was seen at the anterior commissure and the vocal fold length was shortened. Lesions in all three groups were completely covered by neo-mucosa. Collagen proliferation was most prominent in group C with limited scarring in group A. There were no major complications.
Conclusions:
The three operative methods demonstrated satisfactory outcomes; the lesions recovered well over the course of 4 weeks, and no severe complications occurred. The laser surgery protocol was successfully extended into the thyroid cartilage.
