3D-exoscopic microlaryngoscopy in phonosurgery for glottic insufficiency

Area of Science:

• Otolaryngology
• Microlaryngology
• Phonosurgery

Background:

• Glottic insufficiency often leads to dysphonia.
• Vocal fold augmentation with autologous fat is a treatment option.
• The choice of visualization technology impacts surgical procedures.

Purpose of the Study:

• To compare the efficacy of a 3D-exoscope (3Dex) versus a standard operating microscope (OM) in microlaryngoscopic phonosurgery.
• To evaluate the impact of 3Dex and OM on surgical outcomes and voice parameters after vocal fold augmentation.
• To determine if 3Dex is non-inferior to OM for this procedure.

Main Methods:

• A comparative study involving 36 patients with glottic insufficiency undergoing vocal fold augmentation with autologous fat.
• Microlaryngoscopic visualization using either a 3Dex (24 patients) or an OM (12 patients).
• Assessment of voice parameters over a 12-month follow-up period.

Main Results:

• No significant differences were found in operation time or voice parameters between the 3Dex and OM groups.
• Significant improvements in voice quality (excluding roughness) were noted at 3 and 6 months post-surgery.
• A slight decrease in voice quality parameters was observed between 6 and 12 months in both groups.

Conclusions:

• The 3D-exoscope (3Dex) is a viable alternative to the operating microscope (OM) for microlaryngoscopic phonosurgery, offering comparable outcomes.
• Autologous fat vocal fold augmentation significantly improves voice quality in patients with glottic insufficiency.
• 3Dex offers potential advantages in ergonomics and team visualization during phonosurgery.