Postsurgical follow-up study of patients with severe polypoid degeneration.

This report summarizes our experiences with 23 women whose bilateral severe polypoid degeneration was managed surgically and who have been followed over a 2- to 7-year postoperative period. In our study group, polypoid degeneration did not reappear if the patient stopped smoking and practiced healthy vocal hygiene. About 25% of those who continued to smoke after surgery evidenced return of the disease, usually within 2 to 3 years. Reappearance of polypoid degeneration appeared most strongly related to the smoking variable alone or in combination with vocal abuse and/or medications that can cause edema. Neither vocal abuse nor medications appeared to be primary causal factors. The return of polypoid degeneration, in its earliest stages, was detected first via laryngeal examination.

Phonatory characteristics following surgical treatment of severe polypoid degeneration.

This paper summarizes the results of our research into the efficacy of phonosurgery. Our study group consisted of 25 women whose severe, bilateral polypoid degeneration was managed surgically by one of the following methods: Hirano's technique, mechanical stripping, or CO2 laser enucleation. We found that all three procedures improved the voice. Surgery increased the average speaking fundamental frequency level substantially and improved the phonational range. Listeners' judgments about the appropriateness of vocal pitch and severity of hoarseness also changed positively following surgery. No one method was clearly better than another in improving the voice. However, patients treated using Hirano's method experienced the most rapid return of functional voice use, probably because the procedure is less traumatic and promotes more rapid healing than mechanical stripping or laser removal.

Comparison of surgical techniques in the treatment of laryngeal polypoid degeneration.

Surgical excision has been the accepted treatment of laryngeal polypoid degeneration, or chronic polypoid corditis. We report on 29 women with polypoid degeneration who received one of three surgical treatments: vocal fold stripping, carbon dioxide laser obliteration, or the Hirano technique. The duration of postoperative dysphonia was longest with the laser removal and shortest with the Hirano technique. A combination of vocal hygiene management and the Hirano technique of removal provided the most efficacious treatment.

Phonatory characteristics associated with bilateral diffuse polypoid degeneration.

This paper describes the speaking fundamental frequency (SFF) and phonational range characteristics of 35 patients with bilateral diffuse polypoid degeneration. These speakers had average SFFs that were not only substantially lower than normal but also below those associated with many other types of laryngeal pathology. These patients also had phonational ranges that were substantially different from normal. Although both extremes of the pitch range were altered, the upper limit of the voice range was affected profoundly by the morphologic changes in the vocal folds that occur as a result of polypoid degeneration.