Document Detail


Current practice and feasibility in microlaryngeal surgery: microsurgical pressing excision technique.
MedLine Citation:
PMID:  19726987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Since the introduction of endolaryngeal microsurgery, several basic microsurgical techniques have been described for the removal of benign vocal fold lesions. These techniques include conventional incision or dissection, bimanual retraction and cutting, microflap technique and the CO2 laser. Until recently, only a few microsurgical methods have emerged as new choices for the treatment of benign vocal fold lesions. This article introduces an innovative method that can precisely remove benign sessile vocal fold lesions with epithelial keratosis or hyperplasia without jeopardizing the intermediate or deep layer of the lamina propria. RECENT FINDINGS: Instead of using conventional vertically opening microinstruments, this microsurgical pressing excision technique (MPET) utilized two pairs of custom-made horizontally left-opening or right-opening, curved microscissors/curved cupped microforceps to remove right or left vocal fold lesions accordingly. Using one instrument at a time, the lesion was subsequently removed with the microscissors and microforceps in a press-evert-cut manner. Among a total of 553 cases, the treatment results were satisfactory, with 520 (94%) patients retaining a satisfactory/normal (G0) voice 2 months postoperatively. More importantly, no patient's voice was worse postoperatively. SUMMARY: This technique has several advantages: utilizing one instrument at a time can maximize exposure of the narrow endoscopic view, adjusting the pressing force makes precise excision easy in a well controlled horizontal plane. The MPET is particularly useful for removing sessile vocal nodules (especially those with epithelial keratosis), epithelial hyperplasia and leukoplakia in patients with difficult endolaryngeal exposure. This could be a well tolerated and precise microsurgical technique.
Authors:
Ka-Wo Lee; Feng-Yu Chiang
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in otolaryngology & head and neck surgery     Volume:  17     ISSN:  1531-6998     ISO Abbreviation:  Curr Opin Otolaryngol Head Neck Surg     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-12     Completed Date:  2010-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9417024     Medline TA:  Curr Opin Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  431-5     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. kawolee@kmu.edu.tw
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MeSH Terms
Descriptor/Qualifier:
Humans
Laryngeal Diseases / surgery*
Microsurgery / methods*
Surgical Instruments
Vocal Cords / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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