ISSN: 1300 - 6525 E-ISSN: 2149 - 0880
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ORIGINAL RESEARCH

Objective Evaluation Regarding Efficacy of Endolaryngeal Microsurgery
Endolaringeal Mikrocerrahinin Etkinliğinin Objektif Değerlendirmesi
Received Date : 31 Jul 2019
Accepted Date : 10 Dec 2019
Available Online : 22 Apr 2020
Doi: 10.24179/kbbbbc.2019-70912 - Makale Dili: TR
KBB ve BBC Dergisi. 2020;28(2):73-9
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: Benign vocal fold pathologies are the most quality of voice deteriorating etiologic factor after laryngeal infectious and inflammatory diseases considering quality of voice. The most common organic pathologies requiring surgical treatment are vocal cord polyps and reinke edema. These lesions change the frequency and intensity of the voice, besides may cause the sound breaks. Purpose of the present study is to evaluate the effectiveness of cold knife technique with surgery of vocal fold polys and reinke edema. Material and Methods: Fifty-three (22 female, 31 male) adult patients with vocal cord polyp or reinke edema were included in the study. Acoustic voice analysis was performed with Multi Dimentional Voice Program in all patients preoperatively and in the first postoperative month. Results: Postoperative, jitter percentage (Jitt), shimmer percentage (Shim) and noise-harmonic ratio measurements were significantly lower compared to preoperative values. The fundamental frequency (Fo) values also increased statistically in the postoperative period within females operated for reinke edema. Conclucion: The results support that, cold knife technique in endolaryngeal microsurgery can applied successfully to organic lesions.
ÖZET
Amaç: Ses kalitesini, enfeksiyöz ve inflamatuar hastalıklardan sonra en çok bozan etiyolojik nedenler benign vokal kord patolojileridir. En sık cerrahi tedavi gerektiren organik patolojiler vokal kord polipleri ve reinke ödemidir. Bu lezyonlar sesin frekansını ve şiddetini değiştirip, ayrıca seste kırılmalara yol açar. Çalışmanın amacı, vokal kord polibi ve reinke ödemi patolojilerinde soğuk bıçak tekniği ile uygulanan cerrahi tedavinin etkinliğini objektif olarak değerlendirmektir. Gereç ve Yöntemler: Çalışmaya 53 (22 kadın, 31 erkek) vokal kord polip veya reinke ödemi olan erişkin hasta dâhil edilmiştir. Tüm hastalara preoperatif ve postoperatif 1. ayda “Multi Dimentional Voice Program” ile akustik ses analizi yapılmıştır. Bulgular: Tüm hastalar incelendiğinde, postoperatif jitter yüzdesi (Jitt), Shimmer yüzdesi (Shim) ve gürültü-harmonik oranı ölçümleri preoperatif döneme göre istatistiki olarak belirgin düzeyde azalmıştır. Temel frekans (Fo) değerleri ise reinke ödemi olan kadın hastalarda postoperatif dönemde istatistiksel olarak artmıştır. Sonuç: Elde edilen sonuçlar, endolaringeal mikrocerrahide soğuk bıçak tekniğinin, organik patolojilerde başarıyla uygulanabilir bir teknik olduğunu desteklemektedir.
KAYNAKLAR
  1. Demirci Ş, Tüzüner A, Ersöz Ünlü EC, Yavanoğlu A, Arslan N. [Laryngostroboscopic evaluation of the patients with dysphonia]. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2014;67(3).
  2. Comunoglu N, Kocak I, Saygi HI, Yener HM, Batur S, Demiray SB, et al. Dilated minute chambers in laryngeal vocal fold polyps: histopathological and ultrastructural features. J Voice. 2018 Oct 22. Doi: 10.1016/j.jvoice.2018.09.017. [Epub ahead of print]. [Crossref]  [PubMed] 
  3. Wallis L, Jackson-Menaldi C, Holland W, Giraldo A. Vocal fold nodule vs. vocal fold polyp: answer from surgical pathologist and voice pathologist point of view. J Voice. 2004;18(1):125-9. [Crossref]  [PubMed] 
  4. Vasconcelos D, Gomes AOC, Araújo CMT. Vocal fold polyps: literature review. Int Arch Otorhinolaryngol. 2019;23(1):116-24. [Crossref]  [PubMed]  [PMC] 
  5. Agarwal J, Wong A, Karle W, Naunheim M, Mori M, Courey M. Comparing short-term outcomes of surgery and voice therapy for patients with vocal fold polyps. Laryngoscope. 2019;129(5):1067-70. [Crossref]  [PubMed] 
  6. Shoffel-Havakuk H, Sadoughi B, Sulica L, Johns MM 3rd. In-office procedures for the treatment of benign vocal fold lesions in the awake patient: a contemporary review. Laryngoscope. 2019;129(9):2131-8. [Crossref]  [PubMed] 
  7. Byeon HK, Han JH, Choi BI, Hwang HJ, Kim JH, Choi HS. Treatment of hemorrhagic vocal polyps by pulsed dye laser-assisted laryngomicrosurgery. Biomed Res Int. 2015;2015:820654. [Crossref]  [PubMed]  [PMC] 
  8. Sakae FA, Imamura R, Sennes LU, Mauad T, Saldiva PH, Tsuji DH. Disarrangement of collagen fibers in Reinke's edema. Laryngoscope. 2008;118(8):1500-3. [Crossref]  [PubMed] 
  9. Watanabe T, Kaneko K, Sakaguchi K, Takahashi H. Vocal-fold vibration of patients with Reinke's edema observed using high-speed digital imaging. Auris Nasus Larynx. 2016;43(6):654-7. [Crossref]  [PubMed] 
  10. Schyberg YM, Bork KH, Sørensen MK, Rasmussen N. "Cold-steel" phonosurgery of reinke edema evaluated by the multidimensional voice program. J Voice. 2018;32(2):244-8. [Crossref]  [PubMed] 
  11. Sataloff RT, Spiegel JR, Heuer RJ, Baroody MM, Emerich KA, Hawkshaw MJ, et al. Laryngeal mini-microflap: a new technique and reassessment of the microflap saga. J Voice. 1995;9(2):198-204. [Crossref]  [PubMed] 
  12. Ramavat AS, Tiwana H, Banumathy N, Bakshi J, Panda N, Goel A. Efficacy of intralesional steroid injection in small benign vocal fold lesions. Voice. 2019;33(5):767-72. [Crossref]  [PubMed] 
  13. Wang CT, Liao LJ, Huang TW, Lo WC, Cheng PW. Comparison of treatment outcomes of transnasal vocal fold polypectomy versus microlaryngoscopic surgery. Laryngoscope. 2015;125(5):1155-60. [Crossref]  [PubMed] 
  14. Ko CY, Halum SL. Office-based laser surgery of the larynx: cost-effective treatment at the office's expense. Otolaryngol Head Neck Surg. 2012;146(5):769-73. [Crossref]  [PubMed] 
  15. Naunheim MR, Carroll TL. Benign vocal fold lesions: update on nomenclature, cause, diagnosis, and treatment. Curr Opin Otolaryngol Head Neck Surg. 2017;25(6):453-8. [Crossref]  [PubMed] 
  16. Lin YH, Wang CT, Lin FC, Liao LJ, Lo WC, Cheng PW. Treatment outcomes and adverse events following in-office angiolytic laser with or without concurrent polypectomy for vocal fold polyps. JAMA Otolaryngol Head Neck Surg. 2018;144(3):222-30. [Crossref]  [PubMed]  [PMC] 
  17. Díaz-Flores L, Gutiérrez R, del Pino García M, Álvarez-Argüelles H, Díaz-Flores L Jr, López-Campos D. CD34-positive fibroblasts in Reinke's edeme. Laryngoscope. 2014;124(3):E73-80. [Crossref]  [PubMed] 
  18. Berchtold CM, Coughlin A, Kasper Z, Thibeault SL. Paracrine potential of fibroblasts exposed to cigarette smoke extract with vascular growth factor induction. Laryngoscope. 2013;123(9):2228-36. [Crossref]  [PubMed]  [PMC] 
  19. Martins RHG, Tavares ELM, Pessin ABB. Are vocal alterations caused by smoking in reinke's edema in women entirely reversible after microsurgery and smoking cessation? J Voice. 2017;31(3):380.e11-380.e14. [Crossref]  [PubMed]