ENDOSCOPIC MICROSUTURE REPAIR OF VOCAL FOLD DEFECTS

The presence of a nonvibratory segment of vocal folds after microlaryn geal surgery is often a cause of poor voice result. The etiology of a nonvibratory segment is due to full thickness epithelial defect follow ed by secondary wound closure and scar contracture. To reduce scar con tracture and nonvibratory segment of the vocal folds, primary repair w ith a 6-0 chromic endo-knot suture technique was used to dose defects and approximate microflaps of the vocal folds. This was done in 18 pat ients with epithelial defects after resection of benign vocal fold les ions. The pathologic findings included severe polypoid degeneration (n = 7), fusiform laryngeal polyps (n = 5), sulcus vocalis(n = 2), cyst( n = 2), and keratosis (n = 2). Voice was improved in all patients afte r surgery. Comparison of vocal fold vibration before and after surgery showed improvements in configuration, amplitude, and mucosal wave, Vo cal folds that were sutured all had good vibratory characteristics; no ne had a nonvibrating segment at the site of suture placement. Voice a nd healing after microsuture technique were near normal by Day 10 and return of mucosal wave was often complete by Day 14. Endoscopic micros uture closure of microflaps of the vocal folds edge is safe and afford s the surgeon an opportunity for primary repair with improved function al result.