Bipedicled strap muscle transposition for vocal fold deficit after laser cordectomy in early glottic cancer patients.
OBJECTIVE
In treating early glottic carcinomas, the outcomes of endoscopic laser cordectomy have been proven to be valuable in local control, survival, and vocal function preservation. In some extended cases, however, laser cordectomy may leave patients with poor vocal function because of vocal fold deficit. This work assesses the vocal outcome of medialization laryngoplasty with bipedicled strap muscle transposition for vocal fold deficit resulting from laser cordectomy in early glottic cancer patients.


METHODS
A prospective clinical series.


METHODS
Thirteen early glottic cancer patients who had vocal fold deficit caused by previous laser cordectomy underwent medialization laryngoplasty with bipedicled strap muscle transposition. The thyroid lamina on the cordectomy side was paramedially separated. The inner perichondrium was circumspectly raised from the overlying thyroid cartilage. After separating the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally. A bipedicled strap muscle flap was then transposed into the area between the lamina and the paraglottic soft tissue. The thyroid cartilages were carefully sutured back in position. All patients received pre- and postoperative voice assessments comprising laryngostroboscopy and vocal function studies.


RESULTS
Vocal enhancement was present in 92% (12/13) of patients after medialization laryngoplasty with strap muscle transposition. The glottal closure and maximal phonation time were noticeably improved by surgery. No dyspnea or other significant complications were observed in any patients.


CONCLUSIONS
The outcomes show that bipedicled strap muscle transposition is a prosthesis-free, safe, and valuable laryngoplastic technique for correcting glottal incompetence caused by endoscopic laser cordectomy in early glottic cancer patients.
Su
Chih-Ying
CY
Department of Otolaryngology and Speech Center, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
Chuang
Hui-Ching
HC
Tsai
Shang-Shyue
SS
Chiu
Jeng-Fen
JF
D005931:Glottis; D006801:Humans; D007821:Laryngeal Muscles / Q000637:transplantation*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D014827:Vocal Cords / Q000601:surgery*; D014832:Voice Disorders / Q000534:rehabilitation