Vocal cord cyst should be excised with all its walls!
Use a chance get the consultation and treatment from leading ENT specialist of the Royal College of Surgeons of England (FRCS) Professor Roberto Puxeddu
Category: Benign diseases of the larynx
Treatment results
In total, 980 benign
laryngeal lesions have been removed
by Professor Roberto Puxeddu
96% – full voice recovery
100% – proper voice formationSource: Carbon dioxide laser-assisted phonosurgery for benign glottic lesions
Our Doctors:
Roberto Puxeddu
ENT surgeon, Professor, Chairman, Division of Otorhinolaryngology, Department of Surgery, University of Cagliary (Italy). More than 7,000 operations for head and neck diseases have been performed in clinics in Italy and England since 1991. Areas of specialization: neck surgeries, larynx surgery, sinonasal surgeries, intraoral, nasal pharynx and oral pharynx surgeries.
Natalia Chuchueva
Assistant of Roberto Puxeddu in Russia MD, Assistant of the Department of Otorhinolaryngology Sechenov First Moscow State Medical University, ENT doctor in Medical Rehabilitation Center "Barviha" Administration of the President of the Russian Federation. She interned in the clinic of Roberto Puxeddu during the whole year.As a rule, vocal fold cysts belong to those disorders that respond exclusively to phonosurgical treatment. A distinctive feature of the cyst is the presence of epithelial walls, which should be completely isolated and excised.
High-risk group
Women who overuse their voice, often for professional purposes. Such factors as smoking, air pollution, impairment of breathing, GERD increase the risk of cyst formation.
Symptoms
Hoarseness is the main symptom. If the cyst is big in size, there is a feeling that something is stuck in a throat.
Diagnosis and treatment
Diagnosis
Successful treatment requires a thorough differential diagnosis with such laryngeal lesions as vocal cord nodules and pseudocysts. This diagnosis is needed since the approach to excise cysts is different. They should be removed completely with the walls, otherwise a cyst recurs. This surgery is called microsurgery and requires precise work of the surgeon. For this very reason the postoperative period is of high importance. It should include fibrolaryngoscopy, stroboscopy of the larynx, as well as intraoperative diagnosis, which most surgeons do not even think about.
Treatment
The method of choice is surgical excision using a CO2 laser. The entire operation should be performed with a minimal impact on the surrounding tissues of the cyst to prevent scarification. The ideal approach is to use the microflap technique with a careful dissection and excision of all the walls of the cyst.
Cyst excision and postoperative result
Cyst excision of the left vocal cord.
Postoperative result, full voice recovery.
Stages of vocal cord excision
To sum up
Vocal cord cyst can’t be treated conservatively, but it can be successfully excised surgically. Preoperative examination is the key to differential diagnosis with nodules and pseudocysts, which requires a completely different therapeutic approach. Vocal cord cyst should be excised with all its walls, otherwise a cyst recurrence can develop. The surgery is performed under general anesthesia transorally, using a microscope and a CO2 laser.
Exudative lesions of Reinke’s space
A properly performed surgery gets voice back to a person!
Use a chance get the consultation and treatment from leading ENT specialist of the Royal College of Surgeons of England (FRCS) Professor Roberto Puxeddu.
Treatment results
In total, 980 benign
laryngeal lesions have been removed
by Professor Roberto Puxeddu
96% – full voice recovery
100% – proper voice formationSource: Carbon dioxide laser-assisted phonosurgery for benign glottic lesions
Our Doctors:
Roberto Puxeddu
ENT surgeon, Professor, Chairman, Division of Otorhinolaryngology, Department of Surgery, University of Cagliary (Italy). More than 7,000 operations for head and neck diseases have been performed in clinics in Italy and England since 1991. Areas of specialization: neck surgeries, larynx surgery, sinonasal surgeries, intraoral, nasal pharynx and oral pharynx surgeries. Natalia Chuchueva
Assistant of Roberto Puxeddu in Russia MD, Assistant of the Department of Otorhinolaryngology Sechenov First Moscow State Medical University, ENT doctor in Medical Rehabilitation Center "Barviha" Administration of the President of the Russian Federation. She interned in the clinic of Roberto Puxeddu during the whole year.None of the diseases in Reinke’s space affects vocal ligament, the safety of which is a key element of normal voice formation. Properly performed surgery can render the voice to the man.
High-risk group
High-risk group includes smoking people living in conditions of air pollution, people who use their voice intensively. What is more, impaired nasal airflow can be the risk factor, as the dry air can get inside the larynx.
In addition, it was stated that the hyperthyroid affects the overload of the vocal apparatus. Anatomical anomalies, such as the sulcus of the vocal folds, small cicatricial webs in the anterior commissure and GERD do their parts. Combinations of all these factors lead to various macroscopic and microscopic manifestations: polyps, nodules, Reinke’s edema or pseudocysts.
For example, Reinke’s edema develops from cigarette smoking. Voice nodules are typically associated with voice overuse or misuse, so they are called singing. A combination of voice overuse and the presence of factors that reduce the resistance of the body, such as infections, allergies, endocrine diseases lead to polyps or pseudocysts formation. The dominant factor for the angiomatous polyp formation is the recent phonotrauma.
Symptoms
Hoarseness is the symptom that almost all voice disorders have in common.
Diagnostics and Treatment
Diagnostics
A thorough otorhinolaryngologist’s examination is fundamental for the correct diagnosis and the choice of therapeutic approach. Endoscopy is the key standard for the examination. However, for differential diagnosis of the larynx diseases, stroboscopic examination is necessary as well.
Treatment
During the surgical excision of diseases of Reinke’s space, the vocal cord should not be damaged. Only this way allows to achieve the expected result. What is more, the precise use of CO2 laser allows to be a step ahead.
Left vocal fold polyp
Angiomatous polyp of the right vocal fold
Reinke’s edema
To sum up
Exudative lesions of Reinke’s space are polyps, nodules, Reinke’s edema and pseudocysts. The important characteristic which unites them all is their formation in the surperficial layer of the vocal fold, without the involvement of the vocal ligament itself. This fact explains the possibility and at the same time necessitates a conservative surgery, without reducing its effectiveness. Phonosurgical principles should be followed to achieve voice improvement or restoration. The surgery is performed under general anesthesia transorally, using a microscope and a CO2 laser.
