[Functional damage of the larynx].
BACKGROUND
The basic mechanism of the development of functional voice disorders is an excessive collision pressure between the vocal folds during phonation, which occurs between the membranous folds, and/or the vocal processes. Functional-traumatic lesions of the vocal folds appear mainly at the junction between the anterior and the middle thirds of the vocal folds, slightly below the free edge. This is the "predilection site" of the vocal folds, which is the most active part of the vocal folds during phonation, and is therefore mostly exposed to functional-traumatic changes. This study is aimed at establishing the most frequent benign lesions of the vocal folds, which appear at the predilection sites of the vocal folds, and discussing their functional-traumatic aetiology.


METHODS
During the past 10 years 1550 patients underwent various microsurgical procedures for benign lesions of the vocal folds. They were studied for the precise localization of the lesions by the use of indirect videostroboscopy or microstroboscopy, and direct microlaryngoscopy related to the technique which has been used in each particular patient. In this way an overall number of lesions was established, which were located at the predilection sites of the vocal folds, indicating their functional-traumatic aetiology.


RESULTS
It has been established that 1068 lesions (68.6%) were located at the predilection site of the vocal folds (Table 1). Namely, these were nodular lesions, polyps, cysts, and haematoma. Contact hyperplasia appeared at the posterior third of the vocal folds due to a special mechanism of its development.


CONCLUSIONS
Functional-traumatic lesions are mucous stranding, nodular lesions, polyps, cysts, contact hyperplasia and haematoma. All these lesions are either of functional origin or functional voice disorders which contribute, to some degree, to their development.
Milutinović
Z
Z
Department of Otorhinolaryngology, Maxillofacial and Cervical Pathology, Zemun Clinical and Hospital Centre, Belgrade.
D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications* / Q000601:surgery; D014827:Vocal Cords; D014832:Voice Disorders / Q000209:etiology*