Τίτλος:
Vocal fold scars: current concepts and future directions. Consensus
report of the phonosurgery committee of the European laryngological
society
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Scarring of the vocal folds leads to a deterioration of the highly
complex micro-structure with consecutively impaired vibratory pattern
and glottic insufficiency. The resulting dysphonia is predominantly
characterized by a reduced vocal capacity. Despite the considerable
progress in understanding of the underlying pathophysiology, the
treatment of scarred vocal folds is still an unresolved chapter in
laryngology and phonosurgery. Essential for a successful treatment is an
individual, multi-dimensional concept that comprises the whole
armamentarium of surgical and non-surgical (i.p. voice therapy)
modalities. An ideal approach would be to soften the scar, because the
reduced pliability and consequently the increased vibratory rigidity
impede the easiness of vibration. The chosen phonosurgical method is
determined by the main clinical feature: Medialization techniques for
the treatment of glottic gap, or epithelium freeing techniques for
improvement of vibration characteristics often combined with injection
augmentation or implantation. In severe cases, buccal mucosa grafting
can be an option. New developments, include treatment with anxiolytic
lasers, laser technology with ultrafine excision/ablation properties
avoiding coagulation (Picosecond infrared laser, PIRL), or techniques of
tissue engineering. However, despite the promising results by in vitro
experiments, animal studies and first clinical trials, the step into
clinical routine application has yet to be taken.
Συγγραφείς:
Friedrich, G.
Dikkers, F. G.
Arens, C.
Remacle, M.
Hess,
M.
Giovanni, A.
Duflo, S.
Hantzakos, A.
Bachy, V. and
Gugatschka, M.
Περιοδικό:
European Archives of Oto-Rhino-Laryngology: Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS)
Λέξεις-κλειδιά:
Phonosurgery; Vocal fold scars; Sulcus vocalis; Vergeture; Vocal fold
medialization; Micro-flap technique; Buccal mucosa grafting; Laser;
Tissue engineering
DOI:
10.1007/s00405-013-2498-9
