The role of diode laser in the treatment of ventricular dysphonia

Abstract

Objectives: The treatment of ventricular dysphonia (VD) should be based on confirming the true folds pathology. In some patients, the ability of the true folds vibration remains unclear and decision making for performing aggressive surgical interventions can be difficult.

Study design: A retrospective study of surgery by chart review.

Methods: Eight cases with suspicious compensatory type of VD were analyzed in this study. They were all symptom free until a history of endotracheal intubation for laryngeal irrelevant surgery. Their false fold adducted and constricted the supraglottic region sphincterically during phonation. Laser ablation of redundant false folds was performed. After confirming the true folds condition, a second procedure was carried out accordingly within 3 months. The outcome was determined by comparing the difference of the perceptual examination and acoustic parameters before and after each procedure.

Results: Postoperation laryngoscopy revealed the underlying vocal atrophy in five cases and vocal fold palsy in the other three patients. Six of them were treated by medialization thyroplasty or fat augmentation. No significant change in the perceptual evaluation and maximum phonation time was found after laser ablation surgery. Meanwhile, there was no complication such as choking or aspiration after the laser ablation surgery. There was no recurrence of redundant false fold within the mean follow-up of 40 months.

Conclusions: The role of diode laser microlaryngosurgery is not to improve vocal quality but to offer a better visualization of underlying vocal behavior. This facilitated the subsequent prime vocal fold correction surgery. Therefore, we recommend this two-stage treatment modality for patients with compensatory VD.