Marsupialization of vocal fold retention cysts: voice assessment and surgical outcomes.
OBJECTIVE
Although total excision remains the standard treatment for vocal fold retention cysts, postoperative deficits and damage to the vocal folds still occur. Marsupialization is a more conservative technique and can prevent these complications.


METHODS
In this prospective clinical series, 25 patients underwent the marsupialization procedure. Under a direct laryngomicroscope, the cystic wall margin was retracted medially with microforceps. An incision was made with microscissors encircling the equator of the cyst. The cyst contents drained from the cystic cavity when the capsule was sectioned. For 7 patients with concomitant marked vocal fold atrophy, strap muscle transposition laryngoplasty was simultaneously performed.


RESULTS
All patients had complete preoperative and postoperative voice parameter analyses. A subjective improvement in voice quality was reported by 23 of the 25 patients (92%). A small recurrent vocal fold cyst was detected in 1 patient. Small vocal fold deficits and sulcus vocalis were detected in 2 and 4 patients, respectively. Only 1 patient described a worse voice after operation. No other complications were noted.


CONCLUSIONS
Marsupialization of vocal fold retention cysts is a simple, relatively safe, and effective surgical treatment. Voice improvement, a low incidence of recurrence, and minimal vocal fold deficits demonstrate the validity of this technique. Marked preoperative vocal fold atrophy or postoperative glottal gap can be managed with medialization laryngoplasty.
Hsu
Cheng-Ming
CM
Department of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Armas
Gian Luca
GL
Su
Chih-Ying
CY
D000293:Adolescent; D000328:Adult; D000368:Aged; D003560:Cysts / Q000601:surgery*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D007821:Laryngeal Muscles / Q000601:surgery; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome; D014827:Vocal Cords / Q000601:surgery*; D014833:Voice Quality