Characteristics of polypoid lesions in patients undergoing microsurgery of the larynx
24 January 2013
09 March 2013
21 January 2014 (online)
Introduction: Dysphonia is the main symptom of lesions that affect the vocal tract. Many of those lesions may require surgical treatment. Polyps are one of the most common forms of vocal cord lesions and the most prevalent indication for laryngeal microsurgery. There are different types of polyps, and their different characteristics can indicate different prognosis and treatments.
Aim: To conduct a comparative study of polypoid lesions (angiomatous and gelatinous) in patients undergoing laryngeal microsurgery via an electronic protocol.
Method: We prospectively evaluated 93 patients diagnosed with vocal fold polyps; the polyps were classified as angiomatous or gelatinous.
Results: In total, 93 patients undergoing laryngeal microsurgery were diagnosed with vocal fold polyps. Of these, 63 (64.74%) had angiomatous and 30 (32.26%) gelatinous polyps. Most patients with angiomatous polyps were men; their polyps were frequently of medium size, positioned in the middle third of the vocal fold, and accompanied by minimal structural alterations (MSA). In contrast, the majority of patients with gelatinous polyps were women; their polyps were smaller, positioned in the middle and posterior third of the vocal fold, and were not accompanied by MSA. Both types of polyps were more frequently located on the right vocal fold.
Conclusion: Angiomatous polyps were more frequently encountered than gelatinous polyps. In addition, correlations between polyp type and sex, polyp size, position, location, and the presence of MSA were observed. Different surgical techniques were used, but the postoperative results were similar and satisfactory after speech therapy.
- 1 Luchsinger R, Arnold GE. Voice-speech-language. Clinical communicology: It's Physiology and Pathology. Belmont: Wadsworth; 1965
- 2 Martins RH, Defaveri J, Domingues MA, de Albuquerque, Silva R. Vocal polyps: clinical, morphological, and immunohistochemical aspects. J Voice 2011; Jan; 25 (1) 98-106
- 3 Cielo CA, Finger LS, Rosa JC, Brancalioni AR. Lesões Organofuncionias do tipo nódulos, pólipos e edema de Reinke. CEFAC 2011; Jul-Ago; 13 (4) 735-48
- 4 Sociedade Brasileira de Otorrinolaringologia (SBORL). Tratado de torrinolaringologia. São Paulo: Rocca; 2011
- 5 Malafaia O, Borsato EP, Pinto JSP. Manual do usuário do SINPE©. Curitiba: UFPR; 2003
- 6 Pinto JSP. Interface de viabilização de informações para o Sistema Integrado de Protocolos Eletrônicos [dissertation]. [Curitiba]: Universidade Federal do Paraná; 2005. . 111 p
- 7 Catani GSA, Carvalho B, Ido Filho JM, Macedo Filho ED, Pinto JSP, Malafaia O, Stahlke Jr HJ. Proposed computerized protocol for epidemiological study of patients undergoing microsurgery of the larynx. Int Arch Otorhinolaryngol 2012; 16 (3) 346-52
- 8 Woo P, Noordzij JP. Glottal area waveform analysis of benign vocal fold lesions before and after surgery. Ann Otol Rhinol Laryngol 2000; 109: 441-6
- 9 Cecatto S, Costa KS, Garcia RID, Haddad L, Angélico FV, Rapoport P. Pólipos de pregas vocais: aspectos clínicos e cirúrgicos. Rev Bras Otorrinolaringol 2002; 68 (4) 534-8
- 10 Haas E, Döderlein K. Endolaryngeal microsurgery. A report of our experiences in the years from 1966 to 1976. Laryngologie, Rhinologie, Otologie 1978; 57 (3) 235-42
- 11 Mossallam I, Kotby MN, Ghaly AFEA. Histopathological aspects of benign vocal fold lesionsassociated with dysphonia. In: Kirchner JA, , editor. Vocal Fold histipathology: A symposium. San Diego: College-Hill; 1986. p. 65–80
- 12 Lehmann W, Pampurik J, Guyot JP. Laryngeal pathologies observed in microlaryngoscopy. ORL J Otorhinolaryngol Relat Spec 1989; 51 (4) 206-15
- 13 Kleinsasser O. Microlaryngoscopy and endolaryngeal microsurgery. II: A review of 2500 cases. HNO 1974; 22 (3) 69-83
- 14 Eckley CA, Swensson J, Duprat AC, Donati F, Costa HO. Incidência de alterações estruturais das pregas vocais associadas ao pólipo de prega vocal. Rev Bras Otorrinolaringol 2008; 74 (4) 508-11
- 15 Neves BM, Neto JG, Pontes P. Diferenciação histopatológica e himunoistoquímica das alterações epiteliais no nódulo vocal em relação aos pólipos e ao edema de laringe. Rev Bras Otorrinolaringol 2004; 70 (4) 439-48
- 16 Dailey SH, Spanou K, Zeitels SM. The evaluation of benign glottic lesions: rigid telescopic stroboscopy versus suspension microlaryngoscopy. J Voice 2007; 21 (1) 112-8
- 17 Sakae FA, Sasaki F, Sennes LU, Tsuji DH, Imamura R. Pólipos de pregas vocais e alterações estruturais mínimas: lesões associadas? Rev Bras Otorrinolarigol. 2004; 70 (6) 743-8
- 18 Marcotullio D, Magliulo G, Pietrunti S, Suriano M. Exudative laryngeal diseases of Reinke's space: a clinicohistopathological framing. J Otolaryngol 2002; 31: 376-80