Type 3 thyroplasty for patients with mutational dysphonia.

INTRODUCTION: The cases consisted of three men with mutational dysphonia, who were aged 37, 35, and 38 years. The speaking fundamental frequencies (SFFs) at the time of the initial diagnosis were 174.6, 170.2, and 180.0 Hz. METHODS: In all three patients, voice therapy proved ineffective; therefore, surgery was considered. In the anterior-posterior compression test performed preoperatively in the three patients, the voice became low-pitched. RESULTS: The SFFs decreased postoperatively to 106.9, 115.4, and 87.5 Hz, respectively, in the three patients. CONCLUSIONS: Type 3 thyroplasty (TP3) is effective for the treatment of patients with mutational dysphonia in whom voice therapy proved unsuccessful. OBJECTIVE: The SFF of men is high in childhood. At the time of the second pubescent sexual orientation, the frequency usually decreases. However, in some cases, the high-pitched voice of childhood may persist without successful switch to a low-pitched voice during puberty. Thus, there are rare cases of adults with a high-pitched boyish voice. Voice therapy is usually effective for the treatment; however, it may fail in some cases. We performed TP3 for subjects in whom voice therapy proved ineffective. With TP3, the tension of the vocal folds decreases, and the voice becomes low-pitched.

A case of bilateral vocal fold mucosal bridges, bilateral trans-vocal fold type III sulci vocales, and an intracordal polyp.

INTRODUCTION: We present a patient with a novel finding of bilateral mucosal bridges, bilateral type III trans-vocal fold sulci vocales, and a vocal fold polyp. Although sulci and mucosal bridges occur in the vocal folds, it is rare to find multiples of these lesions in a single patient, and it is even more uncommon when they occur in conjunction with a vocal fold polyp. To our knowledge, this is the first description of a vocal fold polyp in combination with multiple vocal fold bridges and multiple type III sulci vocales in a single patient. OBJECTIVE: To describe and visually present the diagnosis and treatment of a patient with an intracordal polyp, bilateral mucosal bridges, as well as bilateral type III trans-vocal fold sulci vocales. METHODS: Presentation of a set of high definition intraoperative photos displaying the extent of the vocal fold lesions and the resection of the intracordal polyp. RESULTS: This patient presented with only 6 months of significant dysphonia. It was felt that the recent change in voice was because of the polyp and not the bridges or sulci vocales. Considering the patient's presentation and the possible morbidity of resection of mucosal bridges and sulci, only the polyp was excised. Postoperatively, the patient's voice returned to his acceptable mild baseline dysphonia, and the benefit has persisted 6 months postoperatively. CONCLUSION: The combination of bilateral mucosal bridges, bilateral type III sulcus vocalis, and an intracordal polyp in one patient is rare if not novel. Treatment of the polyp alone returned the patient's voice to his lifelong baseline of mild dysphonia.