Microlaryngoscopy: A Guide to the Management of Laryngeal Pathologies

Intoduction: Dysphonia is the main symptom of lesions that affect the larynx. Many of those require surgical treatment. Vocal cord lesions are the most common and the most prevalent indication for laryngeal microsurgery. Aim: To conduct a study of laryngeal lesions and their management by microlaryngoscopy. Materials and methods:The main objective being to highlight the importance of microlaryngoscopy in the management of laryngeal pathologies. A total of 147 patients were studied and out of which20 cases were operated under general anaesthesiaduring the study period (Jul 14 – Jun15). History recording and full clinical examination of the patients, examination of blood, sputum for AFB, plain X-rays, CT scan, MRI, ECG were done. The largest possible laryngoscope was used. The working distance was 20 cm. Results: Patients undergoing microlaryngoscopy were diagnosed with vocal cord polys, nodules, Reinke’soedema, keratosis, papilloma, fibroangioma, endocrine small cell carcinoma of vocal cord etc. Most of these patients were female as contrary to various studies where males were common. Microlaryngoscopic excision was both diagnostic and therapaeutic and proved to be an important guide to the management of laryngeal pathologies. Conclusion: Vocal cord polyps were more frequently encountered. In addition, correlations between polyp type and sex, polyp size, position, type of carcinoma, its response to radiotherapy and speech therapy were observed. Different surgical techniques were used. The long term voice results following indirect microlaryngoscopic surgery demonstrated a statistically significant improvement for the maximum dynamic intensity range at habitual speaking pitch.