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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
PubMed
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.

Keywords:
DysphoniaPhonomicrosurgerySurgical flap

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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.