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Endolaryngeal Surgery
Anterior Glottic Web Formation for Voice Feminization: Experience of 27 Patients
Voice feminization is needed for male-to-female transsexuals, males with testicular feminization, and females with constitutional androphonia. Anterior glottic web formation affords advantages: endoscopic surgery without skin incision and scar, outpatient surgery, potential reversibility, and low risk for vocal fold and airway damage.Improved Glottic Exposure for Robotic Microlaryngeal Surgery: A Case Series
Robotic surgery has become the standard of care for many procedures outside of otolaryngology and now is gaining momentum within our specialty. The da Vinci (Intuitive Surgical, Sunnyvale, CA) robot has several advantages to human hands, including removal of tremor and better access to lesions because of increased degree of movement of the articulated instruments. The glottis has rarely been addressed using robotic surgery because access was previously thought to be difficult because of the limitations of currently used retractors, which include poor base of tongue and oral commissure retraction resulting in lack of exposure of the glottis in many patients and lack of space for the robotic instruments to occupy.Transcricothyroid Endoscopic Subglottic Surgery for Posterior Glottic Stenosis: A Case Report
Posterior glottic stenosis (PGS) is a rare but life-threatening condition mostly caused by damage to the interarytenoid mucosa by an endotracheal tube. In surgical treatment of PGS, airway patency is prioritized, and the laryngeal functions involved in swallowing and phonation are considerably sacrificed. In the majority of cases, lateralization of a vocal fold or partial excision of a vocal fold and arytenoid cartilage results in glottal closure insufficiency and deterioration of phonatory function.Amplitude of Glottal Mucosal Wave After Vocal Fold Microflap With or Without Fibrin Glue
The vocal fold microflap technique is the ideal to remove benign vocal fold pathology. Our objective is to compare the amplitudes of the mucosal wave before and after the closure of microflap defect with fibrin glue, and when microflap is left to heal by secondary intention.A Case Report: Hybrid Treatment Approach to Lipoid Proteinosis of the Larynx
Previous research on treatment of lipoid proteinosis has focused on genetic etiology and clinical diagnosis of this rare laryngeal disorder. However, few studies on this disorder have examined treatment methods directed at improving voice qualities. The purpose of this study was to examine a novel hybrid treatment approach and its improvements in the patient's voice quality.Microtrapdoor Flap Technique for Treatment of Glottic Laryngeal Stenosis: Experience With 34 Cases
Laryngeal stenosis is the most challenging disorder for the laryngologist to treat. Microtrapdoor flap technique was described in 1980s; however, it has not been popular since then. The reason may be the difficulty of the technique. In this study, we will report our experience with microtrapdoor flap technique to treat glottic stenosis of 34 patients.Vocal Fold Vibratory Changes Following Surgical Intervention
High-speed videoendoscopy (HSV) captures direct cycle-to-cycle visualization of vocal fold movement in real time. This ultrafast recording rate is capable of visualizing the vibratory motion of the vocal folds in severely disordered phonation and provides a direct method for examining vibratory changes after vocal fold surgery. The purpose of this study was to examine the vibratory motion before and after surgical intervention. HSV was captured from two subjects with identifiable midvocal fold benign lesions and six subjects with highly aperiodic vocal fold vibration before and after phonosurgery.Longitudinal Voice Outcomes Following Advanced CO2 Laser Cordectomy for Glottic Cancer
CO2 laser cordectomy for glottic carcinoma offers excellent oncologic control on a per stage basis as compared with primary radiotherapy. We aim to further investigate the fluctuations of postoperative vocal outcomes following extended laser cordectomy for glottic cancer.The Comparison of Thyroarytenoid Muscle Myectomy and Type II Thyroplasty for Spasmodic Dysphonia
Surgical treatments for adductor spasmodic dysphonia include bilateral thyroarytenoid muscle myectomy (TAM) and type II thyroplasty (TPII), both of which are commonly performed. The present study aimed to compare the effects of TAM and TPII.Voice Outcomes After Transoral Laser Microsurgery for Early Glottic Cancer—Considering Signal Type and Smoothed Cepstral Peak Prominence
This study proposed the use of signal typing and acoustic measures experimentally validated for aperiodic voices to investigate voice outcomes after transoral laser microsurgery (TLM) for early glottic carcinoma. It was of interest whether signal type and pitch-tracking indicators would reveal unreliable perturbation and noise measures. As an alternative, smoothed cepstral peak prominence (CPPS) was used for the first time in this population.Assessment of Voice Quality After Carbon Dioxide Laser and Microdebrider Surgery for Reinke Edema
Surgery of Reinke edema requires reduction of the degenerated superficial lamina propria and preservation of the vibratory epithelium.Treatment of Inflammatory Myofibroblastic Tumor of the Subglottis With KTP Laser: A Case Report
Although inflammatory myofibroblastic tumors (IMTs) are seen in the lower respiratory tract in the pediatric population, few cases occurring in the larynx have been reported in the literature. Treatment of choice is complete surgical excision because of risk of recurrence. We describe a case of pediatric subglottic IMT presenting with progressive hoarseness and symptoms of persistent reactive airway treated with potassium titanyl phosphate laser. We also enumerate the number of pediatric cases of IMT that occur in the larynx and subglottis compared with those which occur in the upper respiratory tract, specifically the trachea and bronchi.Pitch Elevation in Trangendered Patients: Anterior Glottic Web Formation Assisted by Temporary Injection Augmentation
Pitch elevation surgery is most often indicated to assist male-to-female transgendered individuals seeking a more feminine voice quality. Behavioral therapy is primary management but if the desired voice quality is not achieved, surgery is offered. Procedures described that raise vocal pitch alter one or more of the main parameters known to physiologically control pitch; vocal fold tension, length, and mass.Management of Supraglottic Stenosis Using a Novel Stent Design
To present a novel design for a stent for management of a traumatic supraglottic web.New Technique for Preparing Cartilage for Intracordal Injection: The Freezing and Grinding Method
We developed a technique for preparing harvested cartilage that creates finer, more uniform pieces by freezing with liquid nitrogen and grinding with a mortar and pestle. Herein, we report the application of this new technique for intracordal cartilage injection.Chromoendoscopy Associated With Endoscopic Laryngeal Surgery: A New Technique for Treating Recurrent Respiratory Papillomatosis
Chromoendoscopy is a dye enhancement technique that uses epithelial tissue dyeing for assessing any changes in it by determining its characteristics and eventually to improving mucosal lesions detection at endoscopy. Currently with the addition of a joint use of rigid endoscopes and video systems at surgery, visualization of the larynx and trachea areas significantly improved with wide angle viewing. However, in certain diseases, such as laryngeal papillomatosis, certain conditions were overlooked by these approaches and with the likelihood of postoperative early relapse.Suture Lateralization in Patients With Bilateral Vocal Fold Paralysis
To introduce a simplified suture lateralization (SL) technique to treat patients with bilateral vocal fold paralysis (BVFP).Comparison of Effects on Voice of Diode Laser and Cold Knife Microlaryngology Techniques for Vocal Fold Polyps
To compare the effects on voice of endolaryngeal microsurgery (EMS) with cold instruments and a new method, “diode laser,” for vocal fold polyps.Influence of Vortical Flow Structures on the Glottal Jet Location in the Supraglottal Region
Within the fully coupled multiphysics phonation process, the fluid flow plays an important role for sound production. This study addresses phenomena in the flow downstream of synthetic self-oscillating vocal folds. An experimental setup consisting of devices for producing and conditioning the flow including the main test channel was applied. The supraglottal channel was designed to prevent an acoustic coupling to the vocal folds. Hence, the oscillations were aerodynamically driven. The cross-section of the supraglottal channel was systematically varied by increasing the distance between the lateral channel walls.Wendler Glottoplasty: An Effective Pitch Raising Surgery in Male-to-Female Transsexuals
Evaluation of the voice results after Wendler glottoplasty in male-to-female transsexuals (MFTs).Laryngeal Lipotransfer: Review of a 14-Year Experience
To determine the efficacy of lipotransfer for treatment of various vocal fold (VF) pathologies.The Role of Diode Laser in the Treatment of Ventricular Dysphonia
The treatment of ventricular dysphonia (VD) should be based on confirming the true folds pathology. In some patients, the ability of the true folds vibration remains unclear and decision making for performing aggressive surgical interventions can be difficult.KTP 532 nm Laser for Laryngeal Lesions. A Systematic Review
To evaluate the effectiveness and safety of the 532 nm potassium titanyl phosphate (KTP) laser for vocal fold surgery.Photoangiolytic Laser Treatment of Recurrent Respiratory Papillomatosis: A Scaled Assessment
To investigate the effectiveness of unsedated office-based photoangiolytic laser surgery (UOLS) for treating recurrent respiratory papillomatosis (RRP) using the Derkay severity scale, Voice Handicap Index-10 (VHI-10), and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale. Although previous studies examined the effect of UOLS on voice quality, few studies evaluated the effect on disease regression or used accepted and validated scales as outcome measures.Should Antiviral Medications Be Considered Preoperatively for Microlaryngoscopy in Patients With a History of Recurrent Herpes Stomatitis?
Infectious complications following phonomicrosurgery are rare. Reports of herpetic laryngitis are in the literature but none following microlaryngoscopy. We present a case of a 55-year-old female who underwent microsurgical excision of a left vocal fold (VF) lesion and KTP ablation of bilateral vascular ectasias. Postoperative stroboscopy demonstrated severe bilateral VF edema, erythema, and ulcerations of the VFs, encompassing an area greater than the original surgical field. Initial management included voice rest, antibiotics, steroids, and aggressive reflux treatment.
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