Composite myo-mucosal reconstruction of the vocal fold.

It is well established that after cordectomy or radiation therapy for early glottic carcinomas varying disturbances of the voice occur. This has led some clinicians to consider the need for surgical reconstruction of the vocal fold. Since functional results desired have still not been achieved, vocal fold reconstruction was performed using a combination of the muscular flap described by Pogosov and the free mucosal transplant reported by Isshiki. This surgical approach has now been performed on 11 cases with excellent functional results. The technique has provided a suitable mass of the reconstructed vocal fold and also allows very close contact between the vocal folds during the closed phase of the vibratory cycles. Postoperative voice quality has been almost within physiological limits.