- Original article
- Open Access
Subepithelial hydrodissection improves voice outcome of microflap surgery for vocal cord cyst
The Egyptian Journal of Otolaryngology volume 35, pages 51–55 (2019)
The aim was to evaluate voice outcomes of microflap surgery with subepithelial infiltration for vocal fold cysts and to compare voice outcomes of microsurgery with and without subepithelial infiltration for vocal fold cysts.
Patients and Methods
This study was conducted on patients with vocal folds cysts. Patients who met selection criteria were divided into two groups: group A was operated by microflap surgery with subepithelial infiltration, and group B was operated by microflap surgery without subepithelial infiltration.
Within the included 24 patients (12 in each group), a significant improvement of average fundamental frequency/fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, maximal phonation time (MPT), and dysphonia was detected postoperatively in group A (with subepithelial infiltration), with 58.3% of patients resorted to grade 0 dysphonia. Statistically significant improvement of MPT and dysphonia was registered after intervention in group B (without hydrodissection). However, average fundamental frequency/fundamental frequency, jitter, shimmer, and harmonic to noise ratio (HNR) showed nonsignificant improvement after intervention. It was clear that dysphonia improved significantly more in hydrodissection group than nonhydrodissection group (P=0.0063). However, there was no significant difference in postoperative MPT (P=0.3138).
Subepithelial infiltration is beneficial during microflap surgery for vocal fold cysts, with statistically significant better voice results. Therefore, we recommend using this technique during microflap surgery to enhance vocal outcomes; however, further studies are needed on a large number of patients and for a prolonged period of follow-up.
Burns J, Hillman RE, Stadelman-Cohen T, Zeitels SM. Phonomicrosurgical treatment of intracordal vocal fold cysts in singers. Laryngoscope 2009; 119:419–422.
Johns MM. Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps and cysts. Curr Opin Otolaryngol Head Neck Surg 2003; 11:456–461.
Gray SD, Hammond E, Hanson DF. Benign pathologic responses of the larynx. Ann Otol Rhinol Laryngol 1995; 104:13–18.
Courey MS, Garrett GG, Ossoff RH. Medial micro flap for excision of benign vocal fold lesions. Laryngoscope 2008; 137:340–344.
Pawlak A, Hammond T, Hammond E. Immunocytochemical study of proteoglycans in vocal folds. Ann Otol Rhinol Laryngol 2009; 185:6–11.
Elnashar I, El-Anwar MW, Amer H, Quriba A. Voice outcome after Gore-Tex medialization thyroplasty. Int Arch Otorhinolaryngol 2015; 19:248–254.
El-Ahla MAS, El-Anwar MW, Amer HS, Qurib AS. Screw nail medialization of arytenoid in unilateral adductor vocal cord paralysis: a new office procedure. Egypt J Ear Nose Throat Allied Sci 2012; 13:49–53.
Mohamed NN, Sorour SS, El-Anwar MW, Quriba AS, Mahdy MA. Comparison between laser- and diathermy-assisted posterior cordotomy for bilateral vocal cord abductor paralysis. JAMA Otolaryngol Head Neck Surg 2013; 139:923–930.
Nerurkar NK, Shukla SC. Subepithelial vocal fold cyst: a pearl on a string? Int J Phonosurg Laryngol 2012; 2:53–56.
Richtsmeier WJ, Zeitels SM, Vaughan CW. A submucosal true vocal fold infusion needle. Otolaryngol Head Neck Surg 1991; 105:478–479.
Kass ES, Hillman RE, Zeitels SM. Vocal fold submucosal infusion technique in phonomicrosurgery. Ann Otol Rhinol Laryngol 1996; 105:341–347.
Nerurkar NK, Narkar N, Joshi A, Kalel K, Bradoo RA. Vocal outcomes following subepithelial infiltration technique in microflap surgery: a review of 30 cases. J Laryngol Otol 2007; 121:768–771.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
About this article
Cite this article
Merwad, E.A., AbdElftah, M.M., Abdelmonem, S. et al. Subepithelial hydrodissection improves voice outcome of microflap surgery for vocal cord cyst. Egypt J Otolaryngol 35, 51–55 (2019). https://doi.org/10.4103/ejo.ejo_75_18
- cyst recurrence
- microflap dissection
- subepithelial infiltration
- vocal fold cyst