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Effect of Bilateral Vocal Fold Microsuturing on Voice Quality Improvement in Patients With Anterior Glottic Webs: A Retrospective Observational Study

  • Author Footnotes
    # Equal contribution.
    Zhang-Wei Hu
    Footnotes
    # Equal contribution.
    Affiliations
    Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China

    Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
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  • Author Footnotes
    # Equal contribution.
    Lin Chen
    Footnotes
    # Equal contribution.
    Affiliations
    Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China

    Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
    Search for articles by this author
  • Ren-Qiang Ma
    Affiliations
    Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China

    Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
    Search for articles by this author
  • Jie Deng
    Affiliations
    Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China

    Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
    Search for articles by this author
  • Wei-Ping Wen
    Correspondence
    Address correspondence and reprint requests to Wei-Ping Wen and Wen-Bin Lei, The First Affiliated Hospital of Sun Yat-sen University, Department of Otorhinolaryngology, Head and Neck Surgery, No. 58 Zhongshan 2nd Road, Guangzhou 510080 China.
    Affiliations
    Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China

    Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China

    Department of Otolaryngology, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
    Search for articles by this author
  • Wen-Bin Lei
    Correspondence
    Address correspondence and reprint requests to Wei-Ping Wen and Wen-Bin Lei, The First Affiliated Hospital of Sun Yat-sen University, Department of Otorhinolaryngology, Head and Neck Surgery, No. 58 Zhongshan 2nd Road, Guangzhou 510080 China.
    Affiliations
    Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China

    Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
    Search for articles by this author
  • Author Footnotes
    # Equal contribution.
Published:September 17, 2022DOI:https://doi.org/10.1016/j.jvoice.2022.08.016

      Summary

      Purpose

      This study was performed to introduce a modified procedure involving a combination of bilateral vocal fold mucosal flaps and microsurgical sutures for the management of anterior glottic webs and to study its efficacy in decreasing the recurrence rate and improving voice quality.

      Methods

      We retrospectively reviewed 102 patients with anterior glottic webs who underwent surgical treatment by a carbon dioxide laser incision with or without microsurgical suturing in our hospital from May 2014 to April 2021. We focused on the reoperation rate and the voice outcomes based on the 30-item Voice Handicap Index.

      Results

      This study included 102 patients with anterior glottic webs, which were caused by papilloma excision and endoscopic laryngocarcinoma resection in 97 (95.1%) of the 102 patients; less common causes were infection and traumatic injury. All incisions were performed along the midline with a carbon dioxide laser under microscopy and a self-retaining laryngoscope; 37 (36.3%) patients underwent microsurgical suturing and 65 (63.7%) patients did not. The microsuture group had a lower reoperation rate (χ2 = 7.069, P = 0.0078) and higher voice quality (t = 2.054, P = 0.0462) than the non-microsuture group.

      Conclusions

      We introduced a modified procedure that can both decrease the recurrence rate and improve the voice quality in patients with anterior glottic webs. Hence, this combination therapy involving bilateral vocal fold mucosal flaps and microsurgical sutures is worthy of clinical application and promotion.

      Key Words

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