Blog Archives

Augmentation of Vocal Fold Using a Fat Block Implant Following Cordotomy Through a Minithyrotomy Approach in a Rabbit Model

Minithyrotomy vocal fold augmentation using an autologous fat block may soon be feasible in humans undergoing rehabilitation for postcordotomy dysphonia without causing additional damage to the vocal folds.

from the Journal of Voice

Dysphonia secondary to traumatic avulsion of the vocal fold in infants

Conclusions: The mechanisms of injury, risk factors and management of the condition are discussed. Children suffering traumatic intubation require follow up throughout childhood and beyond puberty as their vocal needs and abilities change. At the time of writing, none of the reported patients had yet undergone reconstructive or medialisation surgery. However, regular specialist voice therapy evaluation is recommended for such patients, with consideration of phonosurgical techniques including injection laryngoplasty or thyroplasty.

from the Journal of Laryngology and Otology

Selective lateral laser thyroarytenoid myotomy for adductor spasmodic dysphonia

Conclusion: Selective lateral laser thyroarytenoid myotomy seems to represent a curative procedure for adductor spasmodic dysphonia, a chronic, debilitating condition. This procedure is conceptually simple, minimally invasive and repeatable. It also seems to offer a safe and lasting alternative to botulinum toxin therapy.

from the Journal of Laryngology and Otology

Irradiated macula flava in the human vocal fold mucosa

from the American Journal of Otolaryngology

There have been no investigations regarding radiation-induced damage on human maculae flavae (MFs) in the vocal fold mucosa (VFM) and on stellate cells (SC) in the MF. The VFM, especially MF, after irradiation was investigated histologically.

Materials and methods
The lamina propria of the irradiated VFM was investigated in 5 human adult vocal folds by light and electron microscopy.

Fibroblasts in the irradiated Reinke’s space (RS) showed no morphological changes. Irradiated RS was composed of fibrous tissue with increased collagenous fibers. Most of the SC in the irradiated MF had dark cytoplasm. The nucleus-cytoplasm ratio was relatively small, but there were few intracellular organelles in the cytoplasm. Some SC showed degeneration. Fewer vesicles were present at the periphery of the cytoplasm. The MF was rather deficient in fibrous components. Elastic and collagenous fibers immediately surrounding SC in the irradiated MF were lower in number than usual, but elastic fibers and collagenous fibers composed of irregular collagen fibrils could be detected at a distance from SC. It was suggested that precursors of collagenous and elastic fibers synthesized by SC were damaged by irradiation. Radiation sensitivity of SC was higher than that of conventional fibroblasts in RS, and SC appeared to decrease their level of activity.

Radiation sensitivity of SC was different from that of conventional fibroblasts. Radiation induced not only changes in the lamina propria of the VFM but also dysfunction of the SC in the MF, and is one of the causes of voice disorders after irradiation.

Vascular lesions of the vocal fold

from the European Archives of Oto-Rhino-Laryngology

Abstract The aim of the study was to present symptoms, laryngological findings, clinical course, management modalities, and consequences of vascular lesions of vocal fold. This study examined 162 patients, the majority professional voice users, with vascular lesions regarding their presenting symptoms, laryngological findings, clinical courses and treatment results. The most common complaint was sudden hoarseness with hemorrhagic polyp. Microlaryngoscopic surgery was performed in 108 cases and the main indication of surgery was the presence of vocal fold mass or development of vocal polyp during clinical course. Cold microsurgery was utilized for removal of vocal fold masses and feeding vessels cauterized using low power, pulsed CO2 laser. Acoustic analysis of patients revealed a significant improvement of jitter, shimmer and harmonics/noise ratio values after treatment. Depending on our clinical findings, we propose treatment algorithm where voice rest and behavioral therapy is the integral part and indications of surgery are individualized for each patient.