title: Day surgery for vocal fold lesions using a double-bent 60-mm Cathelin needle.
abstract: Day surgery for vocal cord lesions overcomes the disadvantages of laryngomicrosurgery under general anesthesia. We present our experience with treatment of vocal fold lesions using a long double-bend Cathelin needle that can access all parts of the vocal cords. A 23G, 60-mm-long Cathelin needle was bent twice by 45(o) at a distance of 1 and 2 cm from the tip, and was attached to a syringe. Under topical anesthesia and nasal endoscopy of the laryngopharynx, the needle was inserted percutaneously perpendicular to the skin, the direction of insertion being altered when the bends in the needle reached the skin surface. This allows the tip of the needle to access all parts of the glottis, allowing the performance of procedures such as biopsies, excision of lesions, and injection into the vocal folds. Between January 2011 and December 2013, we used this technique to perform vocal fold procedures in 566 patients presenting for treatment of spasmodic dysphonia (412 cases, 73 %) and other vocal fold lesions. Only minor complications, such as hematoma (3 patients, 0.5 %) and slight bleeding from the puncture site in the epiglottic vallecula (all patients, 100 %), which ceased spontaneously within 10 min, were seen. Erroneous puncture occurred in three patients (0.5 %) and the puncture had to be repeated in 38 patients (6.7 %). The procedure was completed successfully in all cases (100 %). Surgery for vocal fold lesions under topical anesthesia using our double-bend Cathelin needle technique is simple, safe, and useful.
authors.affiliation: Department of Otolaryngology, Tokyo Medical University, 1-6-7 Nishishinjuku Shinjuku-ku, Tokyo, Japan, fumimasatoyomura@yahoo.co.jp.
authors.forename: Fumimasa
authors.initials: F
authors.lastname: Toyomura
authors.forename: Ryoji
authors.initials: R
authors.lastname: Tokashiki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hiramatsu
authors.forename: Kiyoaki
authors.initials: K
authors.lastname: Tsukahara
authors.forename: Ray
authors.initials: R
authors.lastname: Motohashi
authors.forename: Eriko
authors.initials: E
authors.lastname: Sakurai
authors.forename: Masaki
authors.initials: M
authors.lastname: Nomoto
authors.forename: Mamoru
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000295:instrumentation*; D004724:Endoscopy / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D009339:Needles; D012189:Retrospective Studies; D014827:Vocal Cords / Q000601:surgery*