Abstract
To treat hoarseness due to a stiff or cicatricial vocal fold, we developed a new surgical method in which the vocal fold is replaced with a pharyngeal myo-mucosal flap. After the outer surface of the pharyngeal wall was exposed with the superior hone of the thyroid cartilage retracted anteriorly, an island mucosal flap, lined by the thyropharyngeal muscle, was harvested with this muscle elevated as a pedicle. A pharyngeal opening was closed with primary suture. An affected vocal fold was removed by laryngofissure, and the myo-mucosal flap was transferred to the laryngeal lumen along the lateral surface and over the anterior edge of the thyroid ala. A new vocal fold was formed with the mucosal and muscle flap, and the larynx was closed tightly. This surgery was performed in a patient with severe hoarseness after vertical partial laryngectomy. The voice markedly improved by surgery. Vocal function was also improved. Postoperative laryngeal videoendoscopy showed a good closure of the glottis during phonation. No complication with regard to swallowing or respiration occurred. These results suggest that a vocal fold reconstruction using a pharyngeal myo-mucosal flap is a useful surgery for a stiff or cicatricial vocal fold.
