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Bipedicled Vocal Fold Mucosal Flap Use in Phonomicrosurgery: Case Series
Domingos Hiroshi Tsuji1, Vanessa Mika Kinchoku1, Rui Imamura1
1Department of Otolaryngology of the Hospital das Clínicas of the University of São Paulo School of Medicine, São Paulo, Brazil.
Journal of Voice : Official Journal of the Voice Foundation
|April 25, 2020
Summary
This study introduces a novel bipedicled vocal fold mucosal flap technique for repairing vocal fold defects. The method showed significant voice quality improvements, particularly in mucosal wave and breathiness, indicating a safe and effective surgical option.
Area of Science:
- Otolaryngology
- Laryngology
- Surgical Innovation
Background:
- Vocal fold mucosal defects can impair voice quality.
- Existing repair techniques may have limitations.
- Novel surgical approaches are needed to improve outcomes.
Purpose of the Study:
- To present a new surgical technique: the bipedicled vocal fold mucosal flap.
- To evaluate the efficacy of this flap in repairing vocal fold mucosal defects.
- To assess the impact on voice quality and vocal fold function.
Main Methods:
- Retrospective analysis of 6 clinical cases undergoing the bipedicled vocal fold mucosal flap procedure.
- Auditory-perceptual assessment using the Grade-Roughness-Breathiness-Asthenia-Strain (GRBAS) scale.
- Stroboscopic evaluation based on the European Laryngological Society protocol, analyzing glottal closure, mucosal wave, and phase symmetry.
Main Results:
- Significant postoperative improvement in the mucosal wave parameter (P=0.046).
- Significant reduction in overall dysphonia grade (P=0.025) and breathiness (P=0.025).
- The technique was applied successfully in cases of polyps, cysts, sulcus, and mucosal bridges.
Conclusions:
- The bipedicled vocal fold mucosal flap is a safe and effective technique for vocal fold mucosal defect repair.
- It promotes significant improvements in mucosal wave and overall voice quality.
- The technique has the potential to preserve rheological properties and reduce fibrosis.
