title: An Island Flap Technique for Laryngeal Intracordal Mucous Retention Cysts.
abstract: BACKGROUND
  Mucous retention cysts are a subtype of intracordal vocal cysts that may occur spontaneously or may be associated with poor vocal hygiene, and which require optimal treatment. The objective of this study was to present a new laser-assisted microsurgery technique for treating intracordal mucous retention cysts and to describe the final outcomes.
  
  
  METHODS
  In this prospective study, we assessed the pre-operative and post-operative acoustic analysis, maximum phonation time (MPT), and voice handicap index (VHI) of four patients with a diagnosis of mucous retention cyst. The island flap technique was applied to all patients without any complications. In this procedure, we favored the super-pulse mode using a 2-W power CO2 laser to remove the medial wall of the cyst, before clearing away the lateral wall margins of the cyst using repeat-pulse mode and a 2-W power CO2 laser. Indeed, we maintained the underlying epithelium and lamina propria, including the island flap attached to the vocal ligament.
  
  
  RESULTS
  There was a statistically significant improvement in the MPT (pre-op,11.05 s; post-op,15.85 s; P=0.002) and the VHI (pre-operative, 72/120; post-operative,27/120; P=0.001) in all patients. Moreover, jitter and shimmer were refined after surgery, but there was no statistically significant relationship between pre-operative and post-operative data (P=0.071) (P=0.622). In the follow-up period (median, 150 days), there was no report of recurrence or mucosal stiffness.
  
  
  CONCLUSIONS
  The island flap procedure in association with CO2 laser microsurgery appears to be a safe and effective treatment option for intracordal mucous retention cysts, but needs further investigation to allow comparison with other methods.
authors.affiliation: Department of Otorhinolaryngology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Farzad
authors.initials: F
authors.lastname: Izadi
authors.affiliation: Department of Otorhinolaryngology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Ghanbari
authors.affiliation: Department of Otorhinolaryngology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Sahar
authors.initials: S
authors.lastname: Zahedi
authors.affiliation: Department of Otorhinolaryngology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Pousti
authors.affiliation: Department of Otorhinolaryngology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Maleki Delarestaghi
authors.affiliation: Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Salehi
keywords: CO2 laser; Island flap; Mucous retention cyst; Voice analysis.