Improved Mucosal Wave in Unilateral Autologous Temporal Fascia Graft in Sulcus Vocalis Type 2 and Vocal Scars.

OBJECTIVES/HYPOTHESIS: We analyzed the results of 10 patients treated by unilateral autologous temporal fascia graft, comparing the pre and post surgery results, as well as the appearance of the wave and the intervals until the re-appearance of it. STUDY DESIGN: Retrospective, clinical case series. METHODS: Subjective and objective evaluation was preoperatively and postoperatively performed, using laryngovideostroboscopy, the Voice Handicap Index-10, GRBAS (grade, roughness, breathiness, asthenia, and strain), harmonics to noise ratio, Jitter, Shimmer, phonatory range, maximum phonation time, and S/Z ratio in all patients. Postoperative visits were scheduled after 1 week, 1 month, at 3 months, and at 6 months after the surgery. RESULTS: After surgery, we found significant differences in the maximum phonation time and the S/Z ratio (P <0.05). Most parameters of GRBAS also improved significantly, both in general and in the subscales, except for Breathiness and Asthenia (P <0.05). There was an average decrease in Voice Handicap Index-10 of 11.2 (P <0.05). At laryngovideostroboscopy, the mucous wave reappeared in all patients treated 1 month after surgery, and increased in amplitude until 6 months postoperative.

Amplitude of Glottal Mucosal Wave After Vocal Fold Microflap With or Without Fibrin Glue.

INTRODUCTION: The vocal fold microflap technique is the ideal to remove benign vocal fold pathology. Our objective is to compare the amplitudes of the mucosal wave before and after the closure of microflap defect with fibrin glue, and when microflap is left to heal by secondary intention. MATERIALS AND METHODS: The present study is a retrospective series, including 32 patients treated by intracordal phonosurgery, with closure of the microflap either with fibrin glue or by healing by secondary intention. They all had both preoperative and 6-month postoperative track records to allow voice analysis, a subjective Voice Handicap Index 10 (VHI-10), and a good image quality strobe. RESULTS: After selecting the patients was found that the mean overall preoperative VHI-10 was 26.6, and improved up to 10.5 after surgery, a statistical differences (P = 0.03). When comparing both groups, with or without fibrin glue, fibrin glue did not improved results in VHI-10. On the contrary, there was a significant difference in the improvement of the open glottal phase after surgery (P = 0.03), showing a much higher improvement when fibrin glue was used. CONCLUSIONS: The use of fibrin glue after a vocal fold microflap for advanced pathology, such as sulcus vocalis in pocket, vergeture, or vocal fold scar, increases the amplitude of the mucosal wave of the vocal folds, but does not improve the VHI-10 results in our cohort of female patients. So far, patient-reported outcome shows that healing by secondary intention continues to provide excellent voice results.

Otoplastia: resultados del abordaje anterior frente al posterior / Otoplasty: results after anterior versus posterior approach

Introducción y objetivo: En la otoplastia, el abordaje anterior combinado con suturas se utiliza cada día más, dado que es una técnica muy poco agresiva con el cartílago. El objetivo de este estudio es comprobar la utilidad del abordaje anterior, comparándola con el abordaje retroauricular. Material y métodos: Estudio retrospectivo sobre 25 otoplastias intervenidas en el periodo 2004-2008. Se revisa la historia de 13 pacientes (25 otoplastias), con un rango de edad de 7 a 41 años. En el abordaje anterior, el cartílago auricular se adelgaza mediante limado y se modela el pliegue del antehélix mediante suturas. Resultados: De las 25 otoplastias, el 92% fueron bilaterales, con un 54% de niños y un 46% adultos; la anestesia fue local en 20% y general en 80%. El abordaje fue anterior en el 44% y retroauricular en el 56%. Respecto a las complicaciones, en el abordaje anterior hubo extrusiones de puntos en 82%, reacción a cuerpo extraño en 9%, y fue necesaria una cirugía de revisión en el 28% de las 11 otoplastias operadas. En el abordaje posterior, hubo extrusiones de puntos en 21%, reacción a cuerpo extraño en 7%, ulceración de la piel en 7%, siendo necesaria la cirugía de revisión en 7% de las 14 orejas intervenidas. Globalmente, el 85% de los pacientes están satisfechos con el resultado estético de la cirugía. La extrusión de puntos fue estadísticamente más frecuente tras abordaje anterior. Conclusiones: La otoplastia permite obtener buenos resultados estéticos para el tratamiento de las orejas en asa. La complicación más común es la extrusión de puntos de sutura, siendo más frecuente cuando el abordaje es anterior (AU)

Introduction and objective: In otoplasty, an anterior approach with sutures is commonly used, because it is not aggressive with cartilage. The aim of this study on otoplasty was to evaluate the usefulness of the anterior approach, comparing it to the results obtained after the posterior approach. Material and methods: Retrospective study on 25 otoplasties performed at a University Hospital during the period 2004-2008. Clinical records from 13 patients (25 otoplasties), between 7-41 years of age, were reviewed. In the anterior approach, the anterior surface of the auricular cartilage is scratched with a rasp. The antihelix shape is obtained and mattress sutures are placed through the anterior surface of the ear. Results: Out of 25 otoplasties, 92% were bilateral and 8%, unilateral; 54% of the patients were children and 46%, adults; anaesthesia was local in 20% and general in 80%. We performed 11 anterior and 14 posterior approach otoplasties. After an anterior approach, complications were suture extrusion in 82%, foreign body reaction in 9%, and revision surgery was needed in 28% of 11 otoplasties performed. After a posterior approach, complications were suture extrusion in 21%, foreign body reaction in 7%, and revision surgery was needed in 7% of 14 otoplasties performed. A good aesthetic result was obtained in almost all the cases (85%). Extrusion rate was statistically more common after the anterior approach. Conclusions: In our opinion, otoplasty is a simple technique for treatment of prominent ears, with good aesthetic results. The most common complication is suture extrusion, more frequent after an anterior approach (AU)

[Otoplasty: results after anterior versus posterior approach]. / Otoplastia: resultados del abordaje anterior frente al posterior.

INTRODUCTION AND OBJECTIVE: In otoplasty, an anterior approach with sutures is commonly used, because it is not aggressive with cartilage. The aim of this study on otoplasty was to evaluate the usefulness of the anterior approach, comparing it to the results obtained after the posterior approach. MATERIAL AND METHODS: Retrospective study on 25 otoplasties performed at a University Hospital during the period 2004-2008. Clinical records from 13 patients (25 otoplasties), between 7-41 years of age, were reviewed. In the anterior approach, the anterior surface of the auricular cartilage is scratched with a rasp. The antihelix shape is obtained and mattress sutures are placed through the anterior surface of the ear. RESULTS: Out of 25 otoplasties, 92% were bilateral and 8%, unilateral; 54% of the patients were children and 46%, adults; anaesthesia was local in 20% and general in 80%. We performed 11 anterior and 14 posterior approach otoplasties. After an anterior approach, complications were suture extrusion in 82%, foreign body reaction in 9%, and revision surgery was needed in 28% of 11 otoplasties performed. After a posterior approach, complications were suture extrusion in 21%, foreign body reaction in 7%, and revision surgery was needed in 7% of 14 otoplasties performed. A good aesthetic result was obtained in almost all the cases (85%). Extrusion rate was statistically more common after the anterior approach. CONCLUSIONS: In our opinion, otoplasty is a simple technique for treatment of prominent ears, with good aesthetic results. The most common complication is suture extrusion, more frequent after an anterior approach.