Vocal Fold Hyperplastic Lesions: an Evaluation of Surgical Outcome with Videolaryngostroboscopy

摘要

Background: Vocal fold hyperplastic lesions are premalignant lesions that can be treated effectively by removal of the lesions surgically. Aims: The aim of this study was to discuss the success of surgery in patients with vocal fold hyperplastic lesions in terms of preserving vibratory function by comparing the preoperative and postoperative videolaryngostroboscopy findings. Study Design: The medical charts and videolaryngostroboscopic recordings of patients diagnosed with hyperplastic lesions on the vocal folds were reviewed retrospectively. Methods: Twenty seven patients with unilateral lesions who underwent type1 subepithelial cordectomy were enrolled in the study. The videolaryngostroboscopic recordings were evaluated by three raters who were not the operating surgeon and who were blinded to the histology of patients. To evaluate the videolaryngostroboscopic findings, a form, which is a modification of criteria described by Hirano and Bless, was used. Preoperative and 6th month postoperative videolaryngostroboscopic recordings were compared with each other and with recordings of the control group, which included 50 healthy volunteers. Results: All videolaryngostroboscopic findings, except false cord vibration, were significantly improved after surgery. Conclusion: The principle of vocal fold surgery in patients with benign lesions is to preserve the vibratory tissue. This principle also applies to patients with hyperplastic lesions that are premalignant. The hydrodissection technique may be beneficial for this purpose. Turkish Arka Plan: Vokal kordun hiperplastik lezyonlar? lezyonun cerrahi giri?imle ??kar?lmas? sonucunda etkin bir ?ekilde tedavi edilebilen premalign lezyonlard?r. Ama?: Bu ?al??mada vokal kord hiperplastik lezyonu olan hastalar?n ameliyat ?ncesi ve sonras?nda kaydedilen videolaringostroboskopik bulgular? kar??la?t?r?larak cerrahi tedavinin vokal kordun vibratuar fonksiyonlar? üzerine etkisinin tart???lmas? ama?lanm??t?r. ?al??ma Tasar?m?: Hastalar?n hastane dosyalar? ve videolaringostroboskopik kay?tlar? geriye d?nük olarak incelendi. Y?ntemler: Bu ?al??maya tek tarafl? hiperplastik vokal kord lezyonu olan ve Tip 1 subepitelyal kordektomi ile tedavi edilen 27 hasta dahil edildi. Hastalar?n videolaringostroboskopik kay?tlar? hastalar?n ameliyat? ve histopatolojik tan?s? hakk?nda bilgisi olmayan 3 ayr? ki?i taraf?ndan de?erlendirildi. Videolaringostroboskopik kay?tlar?n de?erlendirilmesinde Hirano ve Bless ‘in tan?mlad??? kriterler modifiye edilerek kullan?ld?. Hastalar?n ameliyat ?ncesi ve sonras? 6. ayda kaydedilen videolaringostroboskopi kay?tlar? ve 50 sa?l?kl? ki?iden olu?an kontrol grubuna ait kay?tlar kar??la?t?r?ld?. Bulgular: Cerrahi tedavi sonras?nda hastalar?n yalanc? vokal kord vibrasyonu haricinde tüm videolaringostroboskopi bulgular?nda belirgin düzelme tespit edildi. Sonu?: Benign vokal kord lezyonu olan hastalar?n cerrahi tedavisinde vibratuar dokunun korunmas? gereklidir. Bu husus vokal kordun hiperplastik lezyonlar? i?in de ge?erlidir. Bu ama?la cerrahi esnas?nda “hidrodiseksiyon tekni?i” kullan?labilir.