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Surgical techniques for the removal of vocal fold (VF) disorders that arise within the lamina propria must permit the preservation and/or restoration of VF vibratory characteristics. The endoscopic VF microflap is designed to do such. A retrospective study was undertaken to evaluate the efficacy of this procedure. Forty microflaps (7 bilateral, 1 revision) were performed on 32 patients. Charts and surgical pathology findings were reviewed. Preoperative and 3-month postoperative video recorded voice samples and stroboscopic examination results were compared. Findings on perceptual voice analysis did not significantly change. Stroboscopic examinations revealed improved postoperative VF closure in 27 of 29 patients with impaired preoperative closure and return of mucosal wave in 18 of 24 VFs operated on for the excision of cysts or polyps. When present preoperatively (6 patients), the mucosal wave was preserved. Most patients (28 of 30) rated themselves as clinically improved. The endoscopic VF microflap is efficacious in the treatment of selected VF disorders. The surgical technique is discussed.

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Objective Human papillomavirus (HPV), particularly HPV16, is a causative agent for 25% of head and neck squamous cell cancer, including laryngeal squamous cell cancer (LSCC). HPV positive (HPV+ve) patients, particularly oropharyngeal SCC, have improved prognosis. For LSCC, this remains to be established. The goal was to determine stage and survival outcomes in LSCC in the context of HPV infection. Study Design Historical cohort study. Setting Primary care academic health system. Subjects and Methods In 79 primary LSCC, HPV was determined using real-time quantitative PCR. Chi-square or Fisher’s exact test was used to test association of HPV+ve with 21 risk factors including race, stage, gender, age, smoking, alcohol, treatment, and health insurance. Kaplan-Meier and log rank test were used to study the association of HPV and LSCC survival outcome. Results HPV16 was detected in 27% LSCC. There was a trend towards higher HPV prevalence in Caucasian American (CA, 33%) vs African American (AA, 16%) (p=0.058). HPV was significantly associated with gender (p=0.016) and insurance type (p=0.001). HPV+ve LSCC had a slightly longer survival than HPV-negative (HPV−ve) patients, but the differences were not significant. There was no association with HPV and other risk factors including stage (early vs late). Conclusion We found high prevalence of HPV in males and lower prevalence of HPV infection in AA compared to CA. A slightly better survival for HPV+ve LSCC versus HPV−ve was noted but was not significant. Larger multi ethnic LSCC cohorts are needed to more clearly delineate HPV related survival across ethnicities.

Spasmodic dysphonia has a significant impact on patients' perception of quality of life as measured by the VHI. Significant improvements in all 3 subscale scores and the total score on the VHI occur after treatment with botulinum toxin.