Indirect microlaryngostroboscopic surgery.

Detailed preoperative laryngostroboscopic examination is a prerequisite for phonosurgical correction of organic dysphonia. Although suspension microlaryngoscopic surgery has proved its value in the past, it excludes functional control during the removal of vocal fold swellings. Using an indirect microlaryngostroboscopic surgical technique with topical anesthesia, functional control can be achieved during surgery. This enables the removal of vocal fold swellings with a high degree of precision. Postoperative voice evaluation was performed in 31 patients after suspension microlaryngoscopic or indirect microlaryngostroboscopic surgery. The results showed that indirect microlaryngostroboscopic surgery is at least as good as, and in some respects even better than, suspension microlaryngostroboscopic surgery. Large vocal fold swellings, extensive Reinke's edema, and submucosal swellings are considered less suitable for indirect microlaryngostroboscopic surgery, because such lesions require bimanual instrumentation.