Filippo Carta1, Cinzia Mariani2, Daniela Quartu1, Edoardo Gioia1, Natalia Chuchueva3, Roberto Puxeddu1. 1. Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, University of Cagliari, Cagliari, Italy. 2. Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, University of Cagliari, Cagliari, Italy. cinzia1989@hotmail.it. 3. I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Abstract
PURPOSE: An anterior glottic web consists of the formation of a bridge of scar tissue covered by epithelium between the anterior free edges of the true vocal cords and represents one of the most common complications of laryngeal endoscopic surgery for tumors involving the anterior commissure. Endoscopic surgery is the therapy of choice, but simple section of the web is burdened by a high recurrence rate. Topical application of mitomycin C, intracordal stents, and the use of mucosal microflaps have been proposed to improve outcomes. We report our experience with the use of single and double mucosal microflaps (sliding technique) during the management of iatrogenic anterior glottic web (IAGW). METHODS: From November 2010 to December 2018, 30 patients (29 males, 1 female, mean age 65 years, range 47-87 years) were observed for IAGW, and 11 of these patients (36.7%) required surgical treatment. The Voice Handicap Index (VHI) and the GRBAS were used for the perceptive evaluation of pre- and post-operative voice quality. RESULTS: A reduction of the web length was observed in all cases, and we did not observe any residual web at the mid-third of the glottis. The mean post-operative VHI score decreased from 45 to 24, and the mean post-operative GRBAS values were reduced from 2.8, 2.4, 2.3, 2.1, and 1.1 to 1.9, 1.4, 1.3, 1.1, and 0, respectively. CONCLUSIONS: The microflap technique represents an effective and reproducible one-step procedure that, in expert hands, allows to obtain good anatomical and functional results in a high percentage of cases.
PURPOSE: An anterior glottic web consists of the formation of a bridge of scar tissue covered by epithelium between the anterior free edges of the true vocal cords and represents one of the most common complications of laryngeal endoscopic surgery for tumors involving the anterior commissure. Endoscopic surgery is the therapy of choice, but simple section of the web is burdened by a high recurrence rate. Topical application of mitomycin C, intracordal stents, and the use of mucosal microflaps have been proposed to improve outcomes. We report our experience with the use of single and double mucosal microflaps (sliding technique) during the management of iatrogenic anterior glottic web (IAGW). METHODS: From November 2010 to December 2018, 30 patients (29 males, 1 female, mean age 65 years, range 47-87 years) were observed for IAGW, and 11 of these patients (36.7%) required surgical treatment. The Voice Handicap Index (VHI) and the GRBAS were used for the perceptive evaluation of pre- and post-operative voice quality. RESULTS: A reduction of the web length was observed in all cases, and we did not observe any residual web at the mid-third of the glottis. The mean post-operative VHI score decreased from 45 to 24, and the mean post-operative GRBAS values were reduced from 2.8, 2.4, 2.3, 2.1, and 1.1 to 1.9, 1.4, 1.3, 1.1, and 0, respectively. CONCLUSIONS: The microflap technique represents an effective and reproducible one-step procedure that, in expert hands, allows to obtain good anatomical and functional results in a high percentage of cases.
Entities:
Keywords:
Anterior glottic web; CO2 laser; Dysphonia; Microflap; Microlaryngoscopy
Authors: M Remacle; H E Eckel; A Antonelli; D Brasnu; D Chevalier; G Friedrich; J Olofsson; H H Rudert; W Thumfart; M de Vincentiis; T P Wustrow Journal: Eur Arch Otorhinolaryngol Date: 2000 Impact factor: 2.503
Authors: R Garrel; B Amy de La Bretèque; L Canitrot; A Frery; B Guerrier Journal: Eur Ann Otorhinolaryngol Head Neck Dis Date: 2012-01-13 Impact factor: 2.080