Vokal Kord Polipli Hastalarda Operasyonun Kord Vibrasyonu Üzerine Etkisi: Retrospektif Videolaringostroboskopi Çalışması

Öz

Amaç: Vokal kord polipleri larenkste sık görülen benign lezyonlardır ve tedavileri cerrahidir. Bu lezyonlar genellikle vokal kordun serbest kenarında gelişirler ve vokal kordların vibrasyonunda irregülarite ile birlikte inkomplet glottik kapanma oluştururlar. Bu çalışmada, endolaringeal soğuk bıçak mikrocerrahi yöntemi ile tedavi edilen vokal kord polipli hastalarda; uygulanan operasyonun vokal kord vibrasyonu üzerine etkisinin araştırılması amaçlanmıştır.

Yöntem: Çalışmaya 2014 - 2016 yılları arasında kliniğimizde endolaringeal mikrocerrahi yöntemi ile tedavi edilen, postoperatif patoloji sonucu vokal kord polibi olarak raporlanan ve düzenli olarak kontrollere gelen olgular dâhil edildi. İlk olarak Hirano ve Bless tarafından tanımlanan ve Gürbüz ve ark. yaptığı çalışmada modifiye edilerek güvenilirliği yapılmış olan skala kullanılarak olguların preoperatif ve postoperatif ikinci aydaki görüntüleri istatistiksel olarak karşılaştırıldı.

Bulgular: Çalışmamıza dâhil edilen 25 olgunun 10’u (%40) kadın, 15’i (%60) erkek idi. Vokal kord polipleri olguların hepsinde tek taraflı olup, 12 (% 48) olguda vokal kordun ön 1/3 ünde,  9 (%36) olguda orta 1/3 de saptandı. Bozuk olan vokal kord vibratuar fonksiyonlarının postoperatif dönemde, preoperatif döneme göre istatistiksel olarak anlamlı derecede düzelme gösterdiği saptandı (p ˂ 0,05).

Sonuç: Vokal kord polibi saptanan olgularda başarılı endolaringeal soğuk bıçak mikrocerrahi eksizyonu ile vokal kordların bozulmuş olan vibratuar özellikleri düzeltilebilmektedir. 

Anahtar Kelimeler

• Endolaringeal mikrocerrahi,Polip,Videolaringostroboskopi,vokal kord

Effect of Surgery on Cord Vibration in Patient with Vocal Cord Polyps: Retrospective Videolaryngostroboscopy Study

Abstract

Objectives: Vocal cord polyps are benign lesions of the larynx that are frequently seen and are treated surgically. These lesions generally develop in the free edge of the vocal cords, and form an incomplete glottal closure accompanied by irregular vibration of the vocal cords. In this study, the aim is to investigate the effect of surgery on vocal cord vibration in patients with vocal cord polyps who are treated with the endolaryngeal cold knife microsurgery.

Method: Patients treated with endolaryngeal microsurgery at our clinic between 2014 and 2016, who were reported as vocal cord polyps by postoperative pathology result, and who regularly coming for follow-up examinations were included in the study. Using a scale which was first described by Hirano and Bless and modified and confirmed to be reliable in a study performed by Gürbüz et al., the preoperative and postoperative second month images of the patients were statistically compared.

Results: 10 of the 25 patients included in our study were female (40%) and 15 were male (60%). In all patients, vocal cord polyps were unilateral, and were located in anterior 1/3 of the vocal cord in 12 patients (48%), and in medial 1/3 of the vocal cord in 9 patients (36%). It was determined that impaired vocal cord vibratory functions showed statistically significant recovery in the postoperative period compared to the preoperative period (p<0.05).

Conclusion: Successful endolaryngeal cold knife microsurgery excision can correct impaired vibratory functions of vocal cords in patients with vocal cord polyps. 

Keywords

• Endolaryngeal microsurgery,Polyp,Videolaryngostroboscopy,vokal cord

References

1. 1) R. Loire, M. Bouchayer, G. Cornut. Pathology of benign vocal fold lesions. Ear Nose Throat J. 1988; 67:357-362
2. 2) Barillari MR, Volpe U, Mirra G, Giugliano F, Barillari U. Surgery or Rehabilitation: A Randomized Clinical Trial Comparing the Treatment of Vocal Fold Polyps via Phonosurgery and Traditional Voice Therapy with "Voice Therapy Expulsion" Training. J Voice. 2017; 31(3): 379
3. 3) C.A. Rosen, T. Murry. Nomenclature of voice disorders and vocal pathology. Otolaryngol Clin North Am. 2000; 33:1035-1046
4. 4) K.W. Altman. Vocal fold masses. Otolaryngol Clin North Am, 2007; 40:1091-1108
5. 5) Petrovic-Lazic M., Jovanovic N., Kulic M., Babac S., Jurisic V. Acoustic and perceptual characteristics of the voice in patients with vocal polyps after surgery and voice therapy. Journal of Voice. 2015; 29:241-246.
6. 6) Dursun G., Ertürk A., Kiliç, M.A. Vokal Fold Poliplerinde Endolarengeal Mikrocerrahinin Ses Üzerindeki Etkisi. T Klin J E N T. 2002; 2:78-83.
7. 7) Erdinç M., Gürbüz M. K., Özüdoğru E., Cingi C., Çaklı H., Kaya E., İncesulu A., Keçik C. Vokal kord poliplerinde cerrahi tedavi sonrası ses kalitesinin değerlendirilmesi. J Med Updates 2012; 2:70-75.
8. 8) Ju YH., Jung KY., Kwon SY., Woo JS., Cho JG., Park MW., Park EH., Baek SK. Effect of voice therapy after phonomicrosurgery for vocal polyps: a prospective, historically controlled, clinical study. The Journal of Laryngology & Otology. 2013; 127:1134-1138.

9. 9) Hirano M, Bless DM. Videolaringostroboscopic examination of the larynx. San Diego: Singular Publishing Group; 1993.
10. 10) Gürbüz MK., Birdane L., Açıkalın MF., Çolak E., Özüdoğru E., Cingi C., İncesulu A. Vocal Fold Hyperplastic Lesions: An Evaluation of Surgical Outcome with Videolaryngostroboscopy. Balkan medical journal. 2013; 30:172-177
11. 11) Martins RH, Defaveri J, Domingues MA, de Albuquerque e Silva R. Vocal polyps: clinical, morphological, and immunohistochemical aspects. J Voice 2011; 25:98–106
12. 12) Nunes RB, Behlau M, Nunes MB, Paulino JG. Clinical diagnosis and histologic analysis of vocal nodules and polyps. Braz J Otorhinolaryngol 2013; 79:434–440
13. 13) Filho JM, Carvalho B, Mizoguchi FM, Catani GS, Filho ED, Malafaia O, Stahlke HJ Jr. Characteristics of polypoid lesions in patients undergoing microsurgery of the larynx. Int Arch Otorhinolaryngol 2013; 17:279–284
14. 14) Shapshay SM, Rebeiz EE. Benign lesions of the larynx. In: Bailey B, ed. Head and Neck Surgery-Otolaryngology 1993; 1: 633-634.
15. 15) Wang JS., Olszewski E., Devine EE., Hoffman MR., Zhang Y., Shao J., Jiang JJ. Extension and application of high-speed digital imaging analysis via spatiotemporal correlation and eigenmode analysis of vocal fold vibration before and after Polyp excision. Annals of Otology, Rhinology & Laryngology. 2016; 125:660-666.
16. 16) Sahin M, Gode S, Dogan M, Kirazli T, Ogut F. Effect of voice therapy on vocal fold polyp treatment. European Archives of Oto-Rhino-Laryngology. 2018; 275:1533-1540