Videolaryngostroboscopy following frontolateral laryngectomy with sternohyoid flap. 2004

Walter Paiva Cruz, and Rogério Aparecido Dedivitis, and Abrão Rapoport, and André Vicente Guimarães
Postgraduate Course on Health Sciences of Hospital Heliópolis HOSPHEL, São Paulo, Brazil.

We conducted a retrospective study to analyze the videostroboscopic findings in a group of 21 patients who underwent vertical frontolateral laryngectomy with reconstruction by use of the sternohyoid muscle flap. They had T1b and T2 glottic tumors and a follow-up of more than 1 year. Three observers analyzed the recorded videostroboscopic data. The cases in which the stroboscopic evaluation of the vocal folds was incomplete were studied in regard to the clinical staging, the supraglottic hyperfunction, and the vibratory site; the Fisher exact test was applied. The glottic closure was complete in 15 individuals, and 6 had irregular vocal gaps. The site of vibration was glottic in 10 cases, supraglottic in 7, and mixed in 4. The amplitude was normal on 4 and slightly diminished on 9 preserved sides, whereas it was moderately or severely diminished on 16 and absent on 5 reconstructed sides. The mucosal wave vibratory pattern was always totally present on 15 preserved and 5 reconstructed sides: normal or slightly diminished in the preserved vocal folds, and moderately or severely diminished in the reconstructed ones. The reconstructed vocal folds had a nonvibrating portion in 5 cases. The movement extent of the preserved side was larger than that of the other side in 8 cases, and the sides were similar in 13 cases. The symmetry was regular in 18 cases. The periodicity was always or generally regular in 9 cases. There was supraglottic hyperadduction in 16 cases, with a lateral constriction predominance. The mucosal appearance was normal in 15 patients and wet in 6 patients. The epiglottis was straight in 14 cases and crescent in 7. Mucus formation was observed in 1 patient in the posterior vibratory portion. Videolaryngostroboscopy allowed thorough evaluation of the vibratory pattern of the vocal folds in 52.4% of the patients. The supraglottic hyperadduction component and the supraglottic vocal source presented difficulty for this evaluation. The site of vibration was glottic in 47.6%, supraglottic in 33.3%, and mixed in 19.1% of the cases. The vibratory pattern was diminished on both sides, but mainly on the reconstructed one.

UI MeSH Term Description Entries
D007820 Laryngeal Mucosa The mucous lining of the LARYNX, consisting of various types of epithelial cells ranging from stratified squamous EPITHELIUM in the upper larynx to ciliated columnar epithelium in the rest of the larynx, mucous GOBLET CELLS, and glands containing both mucous and serous cells. Laryngeal Epithelium,Epithelium, Laryngeal,Mucosa, Laryngeal
D007822 Laryngeal Neoplasms Cancers or tumors of the LARYNX or any of its parts: the GLOTTIS; EPIGLOTTIS; LARYNGEAL CARTILAGES; LARYNGEAL MUSCLES; and VOCAL CORDS. Cancer of Larynx,Laryngeal Cancer,Larynx Neoplasms,Cancer of the Larynx,Larynx Cancer,Neoplasms, Laryngeal,Cancer, Laryngeal,Cancer, Larynx,Cancers, Laryngeal,Cancers, Larynx,Laryngeal Cancers,Laryngeal Neoplasm,Larynx Cancers,Larynx Neoplasm,Neoplasm, Laryngeal,Neoplasm, Larynx,Neoplasms, Larynx
D007825 Laryngectomy Total or partial excision of the larynx. Laryngectomies
D007828 Laryngoscopy Examination, therapy or surgery of the interior of the larynx performed with a specially designed endoscope. Laryngoscopic Surgical Procedures,Surgical Procedures, Laryngoscopic,Laryngoscopic Surgery,Surgery, Laryngoscopic,Laryngoscopic Surgeries,Laryngoscopic Surgical Procedure,Laryngoscopies,Procedure, Laryngoscopic Surgical,Procedures, Laryngoscopic Surgical,Surgeries, Laryngoscopic,Surgical Procedure, Laryngoscopic
D008297 Male Males
D009334 Neck Muscles The neck muscles consist of the platysma, splenius cervicis, sternocleidomastoid(eus), longus colli, the anterior, medius, and posterior scalenes, digastric(us), stylohyoid(eus), mylohyoid(eus), geniohyoid(eus), sternohyoid(eus), omohyoid(eus), sternothyroid(eus), and thyrohyoid(eus). Muscle, Neck,Muscles, Neck,Neck Muscle
D010699 Phonation The process of producing vocal sounds by means of VOCAL CORDS vibrating in an expiratory blast of air. Phonations
D005260 Female Females
D005931 Glottis The vocal apparatus of the larynx, situated in the middle section of the larynx. Glottis consists of the VOCAL FOLDS and an opening (rima glottidis) between the folds. Rima Glottidis,Glottidi, Rima,Glottidis, Rima,Rima Glottidi
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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