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European Archives of Oto-Rhino-Laryngology

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01-12-2019 | Dysphonia | Laryngology

Single and double mucosal microflap CO₂ laser “sliding” technique in the management of iatrogenic glottic web: anatomical and functional results

Authors: Filippo Carta, Cinzia Mariani, Daniela Quartu, Edoardo Gioia, Natalia Chuchueva, Roberto Puxeddu

Published in: European Archives of Oto-Rhino-Laryngology | Issue 12/2019

Abstract

Purpose

An anterior glottic web consists of the formation of a bridge of scar tissue covered by epithelium between the anterior free edges of the true vocal cords and represents one of the most common complications of laryngeal endoscopic surgery for tumors involving the anterior commissure. Endoscopic surgery is the therapy of choice, but simple section of the web is burdened by a high recurrence rate. Topical application of mitomycin C, intracordal stents, and the use of mucosal microflaps have been proposed to improve outcomes. We report our experience with the use of single and double mucosal microflaps (sliding technique) during the management of iatrogenic anterior glottic web (IAGW).

Methods

From November 2010 to December 2018, 30 patients (29 males, 1 female, mean age 65 years, range 47–87 years) were observed for IAGW, and 11 of these patients (36.7%) required surgical treatment. The Voice Handicap Index (VHI) and the GRBAS were used for the perceptive evaluation of pre- and post-operative voice quality.

Results

A reduction of the web length was observed in all cases, and we did not observe any residual web at the mid-third of the glottis. The mean post-operative VHI score decreased from 45 to 24, and the mean post-operative GRBAS values were reduced from 2.8, 2.4, 2.3, 2.1, and 1.1 to 1.9, 1.4, 1.3, 1.1, and 0, respectively.

Conclusions

The microflap technique represents an effective and reproducible one-step procedure that, in expert hands, allows to obtain good anatomical and functional results in a high percentage of cases.

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Title: Single and double mucosal microflap CO2 laser “sliding” technique in the management of iatrogenic glottic web: anatomical and functional results
Authors: Filippo Carta
Cinzia Mariani
Daniela Quartu
Edoardo Gioia
Natalia Chuchueva
Roberto Puxeddu
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: Dysphonia
CO2 Laser
Dysphonia
Published in: European Archives of Oto-Rhino-Laryngology / Issue 12/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05632-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Single and double mucosal microflap CO₂ laser “sliding” technique in the management of iatrogenic glottic web: anatomical and functional results

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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