Endoscopic Sealing With a PGA Sheet to Reduce Scarring After Vocal Fold Mucosal Resection

Area of Science:

• Otolaryngology
• Regenerative Medicine
• Speech Science

Background:

• Cordectomy for vocal fold lesions can lead to scarring and impaired voice quality.
• Improving voice preservation after cordectomy is crucial for broader clinical acceptance.

Purpose of the Study:

• To investigate if covering mucosal defects with a polyglycolic acid (PGA) sheet can reduce scar formation.
• To assess the impact of PGA sheets on vocal fold vibratory characteristics and voice outcomes post-cordectomy.

Main Methods:

• A study involving patients undergoing type I or II cordectomy for lateral vocal fold lesions.
• Mucosal defects were either left untreated (control) or covered with a PGA sheet and fibrin glue (PGA group).
• Evaluations included auditory-perceptual (GRBAS), aerodynamic, acoustic, videostroboscopic assessments, and patient-reported quality of life (VHI-10, V-RQOL).

Main Results:

• The PGA group showed significantly lower postoperative Grade scores and longer maximum phonation time compared to the control group.
• Videostroboscopy revealed improved symmetry, glottal closure, and mucosal wave in the PGA group at 3 months, with sustained benefits.
• Roughness was more prominent than breathiness post-surgery, indicating differences in vibratory recovery.

Conclusions:

• Polyglycolic acid (PGA) sheet application with fibrin glue may improve vocal outcomes after superficial cordectomy (predominantly type I).
• This technique shows potential in reducing scar-related vibratory impairment.
• Further research is needed for type II cordectomy defects.