Medial microflap for excision of benign vocal fold lesions

The goal of microlaryngeal surgery is to treat the pathology while preserving or improving vocal function. The medial microflap technique was thus developed. An incision is made over or abutting the lesion, which is then dissected from the vocal ligament and overlying mucosa. Seventeen patients underwent medial microflap excision of their lesions. Postoperative videostroboscopic examinations revealed the presence of mucosal wave and improved glottic closure in 15 of the 17 patients. Acoustic and perceptual analyses revealed improved voice quality. The medial technique is a modification of the previously described lateral microflap technique. Patients whose stroboscopic examination implies lack of involvement of the vocal ligament are candidates for this technique. By identifying normal histologic planes without extensive dissection, lesions can be excised with minimal interruption of vibratory mechanics.