Cotton Ball Self-Retraction Technique: A Novel Surgical Method Used During Microflap Dissection

Area of Science:

• Otolaryngology
• Microsurgery
• Vocal Fold Pathology

Background:

• Vocal cysts are typically treated with microsurgical removal using a microflap technique.
• The conventional microflap technique for vocal cyst removal is technically demanding and associated with a high incidence of cyst rupture.

Purpose of the Study:

• To evaluate the efficacy of a newly developed "cotton ball self-retraction" technique in microflap dissection for vocal cysts.
• To compare the treatment outcomes and recurrence rates of the cotton ball technique versus the conventional microflap technique.

Main Methods:

• A retrospective chart review of 169 patients who underwent microflap surgery for vocal cysts between December 2006 and December 2017.
• Patients were divided into two groups: conventional microflap technique (n=78) and microflap technique with cotton ball self-retraction (n=91).
• Operative data, including cyst rupture rates, and follow-up data, including recurrence rates, were compared between the groups.

Main Results:

• Intraoperative cyst rupture occurred in 53.8% of patients in the conventional group versus 18.6% in the cotton ball group.
• Recurrence rates were 11.5% for the conventional technique and 2.19% for the cotton ball technique.
• Voice outcome improvements were not significantly different between the two groups.

Conclusions:

• The cotton ball self-retraction technique is an effective aid in microflap dissection for vocal cysts.
• This technique significantly reduces intraoperative cyst rupture and long-term recurrence rates.
• The cotton ball technique offers an improved approach to vocal cyst microsurgery.