Office-based treatment of vocal fold polyp with flexible laryngosvideostroboscopic surgery.
OBJECTIVE
To evaluate the usefulness and safety of flexible laryngovideostroboscopic (FLVS) surgery in patients with vocal fold polyp and to discuss its advantages and limitations in comparison with traditional direct microlaryngoscopic technique under general anesthesia.


METHODS
Retrospective analysis.


METHODS
Twenty patients with vocal fold polyp treated by FLVS surgery under topical anesthesia were reviewed. The results were evaluated by videostroboscopy and grade of the severity of dysphonia, roughness, and breathiness (GRB) scales. Phonatory results, including maximum phonation time, jitter, shimmer, and noise to harmonic ratio, were also reviewed for objective evaluations.


RESULTS
All patients completed the surgery smoothly, and seven of them had a higher risk for general anesthesia because of their medical diseases. The procedure was typically accomplished within 20 minutes, and no complications were noted. Videostroboscopy showed improved degree of glottic closure (p < .001), regularity (p = .046), phase symmetry (p = .008), and mucosal wave (p = .008) after FLVS. A significant improvement was noted between preoperative and postoperative results with regard to GRB scale (p < .001, p = .001, and p = .013, respectively). Maximum phonation time also increased significantly after surgery (p = .002). Trivial mucosal residual was noted in one patient. No recurrence was found after a 6-month follow-up period.


CONCLUSIONS
FLVS surgery is a highly applicable procedure with low invasiveness and minimal morbidity. It offers a simple and cost-effective alternative to the traditional direct microlaryngoscopic procedure, especially for those who are not candidates for general anesthesia or suspension of the larynx.
Lan
Ming-Chin
MC
Department of Otolaryngology, Taipei Tzu Chi General Hospital, Taipei, Taiwan.
Hsu
Yen-Bin
YB
Chang
Shyue-Yih
SY
Huang
Jui-Lin
JL
Tai
Shyh-Kuan
SK
Chien
Chih-Hung
CH
Chu
Pen-Yuan
PY
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data*; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D012720:Severity of Illness Index; D013061:Speech Acoustics; D049489:Stroboscopy / Q000379:methods*; D013997:Time Factors; D020535:Video-Assisted Surgery / Q000295:instrumentation*; D014827:Vocal Cords / Q000473:pathology* / Q000601:surgery*; D014833:Voice Quality