| Abstract | Objective
Although voice therapy (VT) is the first option to treat multiple vocal pathologies, part of the patients still requires surgical interventions, and we have been applying multiple office-based surgical procedures. Recently, promising effect of vocal fold steroid injection (VFSI) on multiple inflammatory vocal lesions have been reported. Furthermore, in our super-aging country, patients suffering atrophy and sulcus are increasing. For the glottic insufficiency in these presbylarynx, as well as to treat laryngeal paralysis, we have been performing office-based injection laryngoplasty. Recent reports have proved the effectiveness of basic fibroblast growth factor (bFGF) for these pathologies. Thus, we introduced bFGF as a candidate to replace classic bovine collagen. Additionally, we have been performing office-based green laser surgery (GLS) against RRP.
The purpose of study was to visualize the trend of phonosurgical procedure from OR to Office, as well as to evaluate the impact of office-based surgery against multiple vocal pathologies.
Methods / Design
Retrospective chart review was performed on the patients who had phonosureries except framework surgeries during 2015 to 2022. Number and therapeutic target of surgical options, including microlaryngeal surgery, VFSI, bFGF injection, bovine collagen injection, and GLS were evaluated. Furthermore, therapeutic effect of each office-based technique was examined.
Results
Number of microlaryngeal surgery peaked in 2017, followed by continuous decrease afterward. On the other hand, from 2019 to 2022, we performed 417 office-based surgeries. During this period, due to the COVID-19 pandemic, our aerosol generating procedures using endoscope have been severely monitored to require all office-procedures being performed wearing full-personal protective equipment. However, even under this restricted situation, highest number of office-based surgeries were performed in 2022 (68 surgeries), including 34 GLSs. As for the injection material, bFGF against multiple diseases including atrophy, sulcus, and paralysis are increasing. All of these surgeries were performed safely, with satisfactory vocal results. Typical cases with different types of vocal pathologies treated with office-based surgical options will be shown in this presentation.
Conclusions
Our experience suggested the trend of phonosurgery to treat vocal pathology in the office using less-invasive therapeutic options. Furthermore, office-based therapeutic options were expected to serve satisfactory vocal outcomes.
|
|---|