Pedunculated polyp removal by means of larynx fiberendoscopic surgery

Abstract

To evaluate the stroboscopic and acoustic results obtained with larynx fiberendoscopic surgery (LFS) to remove pedunculated vocal fold polyps. Prospective study, comparing before and after surgery results. We used a series of 31 patients, with a pedicled vocal fold polyp. To remove the pedunculated polyp, we used LFS. This technique consists of excising vocal fold injuries under local anaesthesia by means of micro tweezers using a canal larynx fiberscope. Subjects were evaluated on three occasions: before surgery, 2 and 4 weeks after surgery. After surgery, improvement obtained in stroboscopy examination was statistically significant (p < 0.001) and 100% of the patients had recovered a mucosal wave. After 4 weeks of surgery, all acoustic parameters reached normality ranges. LFS used for the removal of pedunculated vocal fold polyps produces acoustic and stroboscopic improvements, comparable to those obtained using direct laryngoscopy.

Efficacy of percutaneous vocal fold injections for benign laryngeal lesions: Prospective multicenter study

“…However, if patients refuse general surgery or are unable to endure lengthy voice therapy, clinicians need to try other methods. Recently, several studies introduced flexible endoscopic laryngeal surgery under local anesthesia for vocal polyps, and reported good results as regards stroboscopic mucosal findings and voice quality after surgery [8,9]. However, the studies were concerned with just vocal fold polyps.…”

Videolaryngoscopy during Conscious Sedation in Patients Not Suitable for Phonosurgery by Microlaryngoscopy: A Pilot Study

“…The alternative techniques to microlaryngoscopy proposed by other authors involve the use of local anesthesia [4,5,6,7,8,12]. The moderate analgosedation, also called conscious sedation, applied in our proposed method allows the patient to tolerate troublesome procedures by reducing anxiety and pain.…”

“…The technique described by Mahieu and Dikkers [4] presents the limitation of not being able to treat injuries of the vocal folds requiring bimanual running, such as polyps with a large base, large Reinke's edema, and cysts of the vocal folds. All previous alternative techniques [4,5,6,7,8] have been limited to the treatment of benign lesions (polyps and granulomas) or the performance of biopsy for cancerous lesions, probably due to their inability or greater difficulty in the treatment of lesions that require a two-handed approach.…”

“…However, the procedure may be technically difficult or impossible due to alterations of the cervical spine that may not allow hyperextension of the head or may present general anesthesia contraindications [3]. For these reasons, alternative techniques have been proposed [4,5,6,7,8]. However, their use as valuable tools in phonosurgery has not gained popularity.…”

Avances tecnológicos recientes en el diagnóstico y tratamiento de las enfermedades de la laringe y el tracto aerodigestivo superior

“…Recientemente se han introducido al mercado endoscopios flexibles más cortos con fines exclusivamente terapéuticos, dotados con instrumentos que pueden ser utilizados a través de canales para procedimientos por vía transnasal (pinzas, sistemas de inyección). Dentro de las lesiones benignas que pueden ser extirpadas con estas técnicas se prefieren las lesiones polipoides pedunculadas, por la facilidad técnica (62,63), aunque este concepto de facilidad es muy relativo dado que muchas de estas lesiones sangran, dificultando la visualización y la delimitación de las mismas, convirtiéndose el procedimiento en ocasiones en algo técnicamente más complicado que cuando se realiza mediante laringoscopia directa.…”