Ma Matin, Rowshan Ali, Nurul Islam.
Microlaryngoscopic Procedure of Laryngeal lesions- A Clinical study of 100 cases.
Pak J Otolaryngol Jan ;28(3):88-91.

OBJECTIVE: To evaluate the role of microlaryngoscopy in the management of benign laryngeal lesions and T1 glottic carcinoma. To analyze the age and sex distribution,symptomatology,site of involvement,occupational factors and prognosis of various benign laryngeal lesions and T1 glottic carcinoma. STUDY DESIGN: A 10 year prospective study was conducted from July 1999 to June 2010. SETTING: The study was conducted at Maleka Nursing Home,Bogra, Dhaka Medical College Hospital and Rajshahi Medical College Hospital. SUBJECTS AND METHOD: A total of 100 patients(78 males & 22 females) with benign laryngeal lesions and T1 glottic carcinoma were included based on symptomatology of persistent hoarseness or hoarseness and stridor and positive finding of indirect laryngoscopy or flexible nasolaryngoscopy/Telelaryngoscopy.The patients with T2-T4 glottic carcinoma with or without neck nodes were excluded from this study.Microlaryngoscopy was performed in all cases using operative microscope(Atmos,Germany)with 400 mm lens, laryngeal suspension,rigid black anterior commissure laryngoscope and curved towards left,towards right microlaryngeal forceps and scissors except one case of laryngeal web where Diode laser was used.Documentation was done in every case either using camera attachment and TV monitor or taking photograph of pre and post operative microlaryngoscopic view of laryngeal pathology with digital camera.Histopathology was done in all cases of laryngeal pathology excluding laryngeal web and partial cordectomy patient. RESULTS: A male preponderance with a male:female ratio of 3.5:1 was observed.Patients age ranged from 5-75 years(mean age 43.5).Majority of patients were in the age group of 41-50 years. All (100%) presented with persistent hoarseness of voice and stridor was the presenting complaint in 8(8%) cases.Vocal cord polyps(38%) were observed to be the commonest type of benign lesions while invasive squamous cell carcinoma(24%) was the most common neoplastic lesion.Glottal lesions were observed in 90 cases(90%) of which 72 cases involved in right vocal cord. Teacher was found to be the commonest occupation in 30 patients(30%) . All T1 glottic carcinoma got post operative radiotherapy.There was no recurrence in cases of polyps,nodules and haemangiomas with 2 recurrences in T1 glottic carcinoma and multiple papilloma.Significant improvement of voice was noticed in 94 patients(94%). CONCLUSION: Microlaryngeal surgery and voice rest offer a cost effective ,useful and safe method for the management of benign laryngeal lesions with significant voice improvement and minimal recurrence.

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