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Bipedicled Vocal Fold Mucosal Flap: An Experimental Study
Vanessa Mika Kinchoku1, Rui Imamura1, Adriana Hachiya1
1Department of Otolaryngology of Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Journal of Voice : Official Journal of the Voice Foundation
|September 27, 2020
Summary
Augmenting a bipedicled vocal fold mucosal flap does not significantly increase the defect size it can cover. The flap should be approximately 30% larger than the defect width for optimal coverage.
Area of Science:
- Otolaryngology
- Surgical Anatomy
- Laryngeal Reconstruction
Background:
- Vocal fold mucosal defects require reconstructive solutions.
- Bipedicled vocal fold mucosal flaps are a potential surgical option.
- Understanding flap limitations is crucial for successful reconstruction.
Purpose of the Study:
- To determine the maximum dimensions of mucosal defects coverable by bipedicled vocal fold mucosal flaps.
- To assess if augmenting the flap with laryngeal ventricular mucosa increases coverage capacity.
Main Methods:
- Utilized 20 human larynges (10 male, 10 female) from cadavers.
- Created standard and augmented bipedicled vocal fold mucosal flaps.
- Quantified the defect size coverable by each flap type.
Main Results:
- Mean defect width coverable was 1.51 mm (standard flap) and 1.67 mm (augmented flap), with no significant difference.
- Defect size correlated with vocal fold dimensions and flap size in the standard group.
- Standard bipedicled flaps covered larger defects in males.
Conclusions:
- Augmenting bipedicled vocal fold mucosal flaps with ventricular mucosa does not significantly increase defect coverage.
- Flap size should ideally be 30% larger than the defect width.
- A predictive model using vocal fold length, width, and flap size shows high accuracy for standard flaps.
