Surgical treatment of glottic web using butterfly mucosal flap technique: Experience on 12 patients

Abstract

Objectives Many surgical methods have been described for the treatment of glottic web, with very little experience of each. Butterfly mucosal flap technique utilizes superior and inferior mucosal flaps on corresponding surfaces of the web; superior flap is elevated with its base on one vocal fold; and inferior flap is elevated with its base on the other vocal fold. These flaps are sutured to the vocal fold where flap's base is located. This requires four to six microsutures. The disadvantage of this technique is its difficulty. The advantages are single‐stage endoscopic outpatient surgery and high success rate. Methods This is an individual prospective cohort study. All consecutive 12 cases of glottic web were treated with butterfly mucosal flap technique and followed for at least 1 year postoperatively. Voice Handicap Index (VHI)‐30 including physical, functional, emotional, and total scores; acoustic analysis with /a/; aerodynamic measures; and respiratory function tests with a spirometer were determined pre‐ and postoperatively. Results Six patients were male; five were female; and one was male‐to‐female transsexual. Their ages ranged between 9 and 60 years with a mean of 36. All webs were caused by surgical trauma. All webs were cured with one surgery. The postoperative VHI scores, acoustic analysis results, aerodynamic measures, and respiratory function test results of patients improved significantly postoperatively (P < 0.05). Conclusion Although technically difficult, butterfly mucosal flap technique is a very successful single‐stage endoscopic surgical option for the treatment of glottic webs. Level of Evidence 2 Laryngoscope, 129:1423–1427, 2019

Monitoring the Outcome of Phonosurgery and Vocal Exercises with Established and New Diagnostic Tools

“…Due to therapy, most of them rated an improvement from moderately to mildly impaired. ese results correspond to other studies using VHI questionnaires for the investigation of surgical and conservative treatment success in organic dysphonia and functional dysphonia [20,23,[33][34][35][36]. Our overall impression supports the general acknowledgment that short-form VHI versions represent reliable instruments with excellent acceptance and practicability in clinical routine [8,9].…”

“…Overall, our specific therapeutic outcomes confirmed the results of other studies investigating treatment effects in patients with various voice problems [33][34][35][36][37][38][39]. As expected, phonosurgery had the largest numeric impact on the improvement of vocal function.…”

Reconstruct the anterior commissure with intralaryngeal mucosal flap

“…The methods were described in other researches to treat glottic web has a common technique by raising a mucosal flap of the glottic web to cover one or both of the exposed epithelial surfaces of the vocal folds 7‐9 . This technique is useful for the treatment of thin webs.…”

Development of a Bioinspired, Self‐Adhering, and Drug‐Eluting Laryngotracheal Patch

“…Similarly, few effective adjuvant therapies are available for glottic webs beyond keels and stents 47 . Interest in improved management of webs is evidenced by recent studys exploring bovine pericardium as a potential graft material and advanced surgical closure techniques 48, 49 . Our novel patch could fill this role and be used with or without accompanying drug delivery.…”