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Endoscopic Mucosal Rotational Flap for Posterior Glottic Insufficiency: A Case Report
Jessica M L Pagel1, Rachel H Jonas2, James J Daniero3
1University of Virginia School of Medicine, Charlottesville, Virginia, U.S.A.
The Laryngoscope
|September 14, 2024
Summary
This study introduces a new endoscopic CO2 LASER technique for treating posterior glottic insufficiency in professional voice users. The novel flap surgery significantly improved vocal function and quality, restoring the patient
Area of Science:
- Otolaryngology
- Laryngology
- Surgical Innovation
Background:
- Posterior glottic insufficiency (PGI) can cause significant voice impairment, particularly in professional voice users.
- Non-intubation related PGI presents unique challenges for surgical correction.
- Previous treatments for PGI have shown limited success in some patients.
Observation:
- A 78-year-old professional voice user presented with progressive dysphonia and dyspnea due to PGI.
- Stroboscopic examination confirmed posterior glottic insufficiency as the cause of symptoms.
- The patient did not respond to conservative voice therapy.
Findings:
- A novel endoscopic CO2 LASER-assisted posterior glottic rotation flap was successfully performed.
- Postoperative Voice Handicap Index-10 (VHI-10) scores improved from 25 to 9.
- Overall Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) scores improved from 69 to 6.5.
- The patient regained the ability to public speak and lecture.
Implications:
- This endoscopic CO2 LASER technique offers a viable surgical option for PGI.
- The procedure demonstrates significant potential for restoring vocal quality and function.
- Further research may explore this technique in a broader patient population with PGI.
