Symptomatic and asymptomatic hemorrhagic cysts of the vocal folds [corrected].
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Biomedical subjects
Publications and source records attributed to M J Hawkshaw.
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Vocal fold surgical technique has advanced substantially because of increased knowledge regarding anatomy and physiology of phonation and because of technological improvements. However, many new techniques have been based on anecdote and "common sense," largely because there is no good experimental model for vocal fold surgery since the human is the only species with a vocal ligament. Consequently, our earlier pronouncements require careful reexamination especially as new research adds to our fund of knowledge. Review of the principles and results of laryngeal microflap surgery suggests that there may be important shortcomings in the technique. A new mini-microflap technique appears better, as does limited mucosal resection. This is a preliminary report, and further investigation is needed.
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Strobovideolaryngoscopy is a valuable addition to the diagnostic armamentarium because it allows the otolaryngologist to perform a detailed physical examination of the vibratory margin of the vocal fold. From 1985 through 1989, we performed 1,876 strobovideolaryngoscopy procedures, the majority on professional voice users. Previously, we reported findings on our first 486 strobovideolaryngoscopy procedures. Stroboscopic information influenced diagnosis or treatment in approximately one third. The present study was undertaken to determine whether additional experience had altered the clinical usefulness of the procedure. Diagnoses were noted before and after stroboscopy prospectively for 377 strobovideolaryngoscopy procedures performed during the calendar year 1989. In 53% of the procedures, strobovideolaryngoscopy resulted in no change in diagnosis. In 29%, preprocedure impressions were confirmed and additional diagnoses were made. In 18%, preprocedure diagnoses were found to be incorrect. The procedure has proven very helpful in caring for voice patients, modifying diagnoses in 47%, and confirming uncertain diagnoses in many of the other patients studied.