Recurrent Laryngeal Papillomatosis, Juvenile and Adult: 1990‐2010

Abstract

Objective: Evaluate quality of life as well as quality of voice before and after endoscopic injection augmentation with Polydimethylsiloxane (VOX-Implants) for unilateral neurogenic vocal fold immobility.Method: Prospective study. Evaluation of 14 patients undergoing injection laryngoplasty (VOX-Implants) under general anesthesia. Evaluation of the following parameters concerning the patients voice (preoperatively, postoperatively): glottic closure (videostroboscopic and flexible-videoendoscopic), voice range profile, maximum phonation time, Dysphonia index (according to Friedrich) and Roughness-BreathinessHoarseness-Scale (RBH-Scale). Quality of life was assessed using Voice-Handicap-Index (VHI-12).Results: Postoperatively an improvement was evident in all observed parameters. A sufficient glottic closure during phonation could be accomplished in all patients. The voice range profile increased about 3.65 half-tones. After injection laryngoplasty maximum phonation time was 6.9 seconds longer than preoperatively. The Friedrich Dysphonia-Index was 2.4 before and 1.3 after augmentation. Postoperatively RBH-scale was lower than before the operation. Voice-Handicap-Index (VHI-12), a parameter for experienced voice handicap in private life, could be declined to 15.7 points postoperatively. In our study no substance-associated complications were observed. Conclusion:Injection laryngoplasty with Polydimethylsiloxane (VOX-Implants) is an effective instrument to improve the quality of voice as well as the quality of life in patients with an unilateral vocal fold paralysis. Polydimethylsiloxane is a safe substance for injection laryngoplasty and provides satisfying results in the reestablishment of patients communication ability. Laryngology/Broncho-Esophagology Recalcitrant Airway Stenosis in Patients with Abnormal ScarsPaulette Pacheco (presenter); Evamariely Garcia; Carlos Gonzalez-Aquino, MDObjective: 1) Identify factors that lead to failures in laryngotracheal reconstruction. 2) Substantiate the clinical suspicion that patients with aberrant wound healing are more likely to fail initial reconstruction surgery, requiring multiple procedures. 3) Consider this population for research in the genetics of subglottic and tracheal stenosis.Method: A retrospective chart review of patients who failed initial laryngotracheal reconstruction surgery and required additional procedures. The main outcome measure was decannulation. We evaluated demographic data, cause of stenosis, Cotton-Myer grade, surgical techniques, medications employed, and whether patients presented evidence of aberrant wound healing in other anatomic sites.Results: Six records were identified. Five of these (83%) demonstrated hypertrophic scarring on physical examination. The cause of stenosis in every patient was mechanical ventilation ranging from 5 to 20 days. All patients presented with Cotton grades 3 or 4. Although surgical technique did not vary among patients, all underwent a minimum of three interventions over a 2-year period, despite the regular use o...