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J Voice 2021 Aug 2. Epub 2021 Aug 2.

Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada; Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada.

Objectives: The objective of this study was to evaluate the efficacy of immediate injection treatments of dexamethasone, hyaluronic acid (HA)/gelatin (Ge) hydrogel and glycol-chitosan solution on the phonatory function of rabbit larynges at 42 days after surgical injury of the vocal folds, piloting a novel ex vivo phonatory functional analysis protocol.

Methods: A modified microflap procedure was performed on the left vocal fold of 12 rabbits to induce an acute injury. Animals were randomized into one of four treatment groups with 0. Read More

Laryngoscope 2022 03 3;132(3):612-618. Epub 2021 Aug 3.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Objectives/hypothesis: Anterior glottic stenosis (AGS) results from surgical intervention, carcinoma, papillomatosis, congenital, or idiopathic causes. It may be present as elastic web or fibrotic scar. It impairs vocal function and glottic airway. Read More

Sci Rep 2021 06 29;11(1):13484. Epub 2021 Jun 29.

Department of Rehabilitation Medicine, NYU Grossman School of Medicine, New York, NY, USA.

Vocal fold (VF) fibrosis is a major cause of intractable voice-related disability and reduced quality of life. Excision of fibrotic regions is suboptimal and associated with scar recurrence and/or further iatrogenic damage. Non-surgical interventions are limited, putatively related to limited insight regarding biochemical events underlying fibrosis, and downstream, the lack of therapeutic targets. Read More

Front Pediatr 2019 8;7:532. Epub 2020 Jan 8.

IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Pediatric Laryngo-Tracheal Stenosis (LTS) comprises different conditions that require precise preoperative assessment and classification. According to the guidelines, the optimal diagnostic work-up of LTS patients relies both on a comprehensive anamnesis and on endoscopic and radiological assessments. All the causes of LTS result in an impairment in airflow, mucociliary clearance, phonation, and sometimes in swallowing disorders. Read More

Eur Arch Otorhinolaryngol 2019 Dec 13;276(12):3405-3412. Epub 2019 Sep 13.

Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria Di Cagliari, University of Cagliari, Cagliari, Italy.

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. Read More

Eur Arch Otorhinolaryngol 2019 Aug 29;276(8):2289-2292. Epub 2019 May 29.

Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai New York, New York, NY, USA.

Purpose: Vocal fold scar is one the most challenging benign laryngeal pathologies. The purpose of this paper is to propose a classification that will allow for a common description of this entity between laryngologists, prevent discrepancies in interpretation, allow for comparison of related studies, and offer a training tool for young laryngologists.

Methods/results: Based on the depth and laterality of scarring, we propose 4 types: type I, characterized by atrophy of lamina propria with/without affected epithelium; type II, where the epithelium, lamina propria, and muscle are affected; type III, where the scar is located on the anterior commissure; type IV, which includes extended scar formation in both anteroposterior and rostro-caudal axis with significant loss of vocal fold mass. Read More

mSphere 2019 05 1;4(3). Epub 2019 May 1.

Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA

Laryngotracheal stenosis is an obstructive respiratory disease that leads to voicing difficulties and dyspnea with potential life-threatening consequences. The majority of incidences are due to iatrogenic etiology from endotracheal tube intubation; however, airway scarring also has idiopathic causes. While recent evidence suggests a microbial contribution to mucosal inflammation, the microbiota associated with different types of stenosis has not been characterized. Read More

Laryngoscope 2019 02 12;129(2):441-447. Epub 2018 Sep 12.

Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, New York, U.S.A.

Objectives/hypothesis: We describe the clinical features of granulomas of the membranous vocal fold secondary to endotracheal intubation, bronchoscopy or esophagogastroduodenoscopy.

Study Design: Retrospective case series.

Methods: Review of cases at a single tertiary institution with evaluation of patient demographic characteristics, time to presentation, time to treatment, and clinical outcomes. Read More

Dis Model Mech 2016 11 16;9(11):1397-1403. Epub 2016 Sep 16.

Department of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA

Subepithelial changes to the vocal fold mucosa, such as fibrosis, are difficult to identify using visual assessment of the tissue surface. Moreover, without suspicion of neoplasm, mucosal biopsy is not a viable clinical option, as it carries its own risk of iatrogenic injury and scar formation. Given these challenges, we assessed the ability of high- (4. Read More

Rev Laryngol Otol Rhinol (Bord) 2013 ;134(1):61-4

GHM Portes du Sud, 69200 Vénissieux, France.

Between January of 2007 and December of 2011, six patients underwent revision microphonosurgery because of scarring complicating the initial surgery. The technique consisted of detaching the scarred area, the insertion of fibrils of hyaluronic acid (Merogel), a microsuture and possibly intra-cordal fat injection. A pre-and post-operative phoniatric protocol assessed the results which appear encouraging. Read More

Rev Laryngol Otol Rhinol (Bord) 2014 ;135(2):57-61

Objectives: Patients with iatrogenic scarring of the vocal folds can present with a spectrum of dysphonia ranging from slight hoarseness to very severe dysphonia. In this paper we will describe the clinical and stroboscopic presentation of VFIS, and discuss the possibility of identifying the factors favouring such lesions.

Study Design: A retrospective chart review from 2002 to 2011. Read More

Acta Otorhinolaryngol Ital 2011 Jun;31(3):154-60

Otolaryngology Department, Fondazione IRCCS Ca’ Granda Maggiore Policlinico Hospital, Milan, Italy.

Aims of this prospective study were to evaluate the results of vocal fold structural fat grafting for glottic insufficiency and to compare the outcomes obtained in unilateral vocal fold paralysis (UVFP) and congenital or acquired soft tissue defects in vocal folds. Sixty-six consecutive patients with breathy dysphonia, in 43 cases (aged 16-79 years) related to UVFP and in 23 cases (aged 16-67 years) related to vocal fold iatrogenic scar or sulcus vocalis, underwent autologous structural fat grafting into vocal folds. Lipoaspirates were centrifuged at 1200 g for 3 min to separate and remove blood, cell debris and the oily layer. Read More

Curr Opin Otolaryngol Head Neck Surg 2010 Dec;18(6):487-91

Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.

Purpose Of Review: Vocal fold scar is generally caused by trauma or from iatrogenic causes such as intubation, radiation therapy or phonomicrosurgery. Once a vocal fold scar has occurred it becomes a difficult problem to treat. There are many different tools that otolaryngologists use for vocal fold scar treatment. Read More

Otolaryngol Head Neck Surg 1996 Nov;115(5):474-82

Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan, USA.

Scarring of the vocal folds can occur as the result of blunt laryngeal trauma or, more commonly, as the result of surgical, iatrogenic injury after excision or removal of vocal fold lesions. The scarring results in replacement of healthy tissue by fibrous tissue and can irrevocably alter vocal fold function and lead to a decreased or absent vocal fold mucosal wave. The assessment and treatment of persistent dysphonia in patients with vocal fold scarring presents both diagnostic and therapeutic challenges to the voice treatment team. Read More