Phonomicrosurgery for Benign Vocal Fold Lesions Using Medial-microflap Technique with Cold Instruments in a Teaching Hospital of India

Background: Phonomicrosurgery is a challenging and evolving field. One of the key techniques used for this is micro-flap technique used along with cold micro instruments. Objective: To convey the role of Microflap technique in phonosurgery and the role of basic microlaryngeal instrumnets in such surgery when sophisticated phonomicrosurgical instruments are not available. Methods: This is a retrospective study of 33 patients of benign vocal fold lesions who have undergone phonomicrosurgery using microflap technique from the year January 2011 to January 2016. Majority of these cases were vocal nodules (16cases) followed by Cyst in the vocal cord (10 cases) and 5 cases of polyps. Results: Cases were analyzed using GRBAS scoring and stroboscopic findings. A significant improvement was noted in the voice outcome of these patients except two cases where endoscopic paraglottic fat injection was done along with hyaluronic acid with steroid infiltration into the Reinke’s space, after which there was improvement in voice. Conclusion: Microflap technique for vocal fold lesion is a unique surgical procedure that allows preservation of vocal cord morphology and at the same time prevents post surgical scarring with excellent voice outcome. ThisThis surgery can be performed with good quality regular microsurgical instruments.