Abstract
With the introduction of the laryngomicrosurgical techniques including sucking, squeezing, and pinching methods, marked improvement of postoperative results has been obtained in treating polypoid degeneration of vocal folds. In some cases, however, unexpected hoarseness continued after the operation. Since 1989 there have been nine such cases treated at our clinic. The causes of postoperative hoarseness were (1) over-resection of vocal mucosa in three cases, (2) recurrence of vocal edema in five cases and (3) phonation using false vocal folds in one case. Reoperation was necessary in a case of over-resection of vocal mucosa with a web at the anterior commissure and in two cases of recurrence of vocal edema, all of whom had been treated at other clinics. Steroid injection to the edematous vocal fold in two cases and polypotomy in a case using fiberoptic laryngeal surgical technique were performed yielding good results.
Over-removal of the mucosa, especially at the free mucosal edge and the anterior commissure, should be prevented as countermeasures for post-operative hoarse voice in laryngomicrosurgical treatment of polypoid vocal folds. Postoperative long-term follow up and early detection of recurrence also seemed important. To settle the recurrent polypoid vocal fold at an early stage, fiberoptic steroid injection manifested its effectiveness.
