Contribution to therapy of dysphonia plica ventricularis.

Excision of the hypertrophic ventricular folds was performed in 35 patients by means of laryngomicroscopy. In most of our patients this therapy promptly resulted in a clear voice. Correlating the laryngomicroscopic finding and the histological picture we were able to classify hypertrophy of the ventricular folds into three stages, each of which presents with a characteristical clinical and histological picture and thus requires approapriate therapy. In Stage I the histological changes are reversible and conservative phoniatric therapy leads to success relatively quickly. In the second stage histological changes may also be reversible, and the prolonged and persistent phoniatric therapy leads to success but we prefer microsurgical excision because of the direct effect. In Stage III, however, we found irreversible histological changes in the sense of connective hyperplasia which prompted us to conclude that microsurgical excision alone may lead to regression of the hoarseness.

[About some changes of the vocal cord mucosa and of Reinke's Subepithelial space (author's transl)]. / Uber einige Veränderungen an der Stimmlippenschleimhaut und im Reinkeschen Raum

The mechanical irritation alone or in combination with an inflammatory component and fragility of blood vessels plays the decisive role in the development of some vocal cord morphological changes. The duration of the mechanical irritation modifies the clinical picture. The plase of the strongest physiological mechanical irritation is the place of localization of the vocal cord morphological changes. The histological picture of different pathomorphological vocal cord changes is almost identical, this being the consequence of the specific structure of Reinke's subepithelial space. The treatment of all these morphological entities is surgical by means of microlaryngoscopy, except in cases of recent nodules which respond to conservative phoniatric therapy in the majority of cases.