Vocal fold scars: current concepts and future directions. Consensus report of the Phonosurgery Committee of the European Laryngological Society
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Vocal fold scars: current concepts and future directions. Consensus report of the Phonosurgery Committee of the European Laryngological Society. / Friedrich, G; Dikkers, F G; Arens, C; Remacle, M; Hess, M; Giovanni, A; Duflo, S; Hantzakos, A; Bachy, V; Gugatschka, M; European Laryngological Society. Phonosurgery Committee.
In: EUR ARCH OTO-RHINO-L, Vol. 270, No. 9, 01.09.2013, p. 2491-507.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Vocal fold scars: current concepts and future directions. Consensus report of the Phonosurgery Committee of the European Laryngological Society
AU - Friedrich, G
AU - Dikkers, F G
AU - Arens, C
AU - Remacle, M
AU - Hess, M
AU - Giovanni, A
AU - Duflo, S
AU - Hantzakos, A
AU - Bachy, V
AU - Gugatschka, M
AU - European Laryngological Society. Phonosurgery Committee
PY - 2013/9/1
Y1 - 2013/9/1
N2 - Scarring of the vocal folds leads to a deterioration of the highly complex micro-structure with consecutively impaired vibratory pattern and glottic insufficiency. The resulting dysphonia is predominantly characterized by a reduced vocal capacity. Despite the considerable progress in understanding of the underlying pathophysiology, the treatment of scarred vocal folds is still an unresolved chapter in laryngology and phonosurgery. Essential for a successful treatment is an individual, multi-dimensional concept that comprises the whole armamentarium of surgical and non-surgical (i.p. voice therapy) modalities. An ideal approach would be to soften the scar, because the reduced pliability and consequently the increased vibratory rigidity impede the easiness of vibration. The chosen phonosurgical method is determined by the main clinical feature: Medialization techniques for the treatment of glottic gap, or epithelium freeing techniques for improvement of vibration characteristics often combined with injection augmentation or implantation. In severe cases, buccal mucosa grafting can be an option. New developments, include treatment with anxiolytic lasers, laser technology with ultrafine excision/ablation properties avoiding coagulation (Picosecond infrared laser, PIRL), or techniques of tissue engineering. However, despite the promising results by in vitro experiments, animal studies and first clinical trials, the step into clinical routine application has yet to be taken.
AB - Scarring of the vocal folds leads to a deterioration of the highly complex micro-structure with consecutively impaired vibratory pattern and glottic insufficiency. The resulting dysphonia is predominantly characterized by a reduced vocal capacity. Despite the considerable progress in understanding of the underlying pathophysiology, the treatment of scarred vocal folds is still an unresolved chapter in laryngology and phonosurgery. Essential for a successful treatment is an individual, multi-dimensional concept that comprises the whole armamentarium of surgical and non-surgical (i.p. voice therapy) modalities. An ideal approach would be to soften the scar, because the reduced pliability and consequently the increased vibratory rigidity impede the easiness of vibration. The chosen phonosurgical method is determined by the main clinical feature: Medialization techniques for the treatment of glottic gap, or epithelium freeing techniques for improvement of vibration characteristics often combined with injection augmentation or implantation. In severe cases, buccal mucosa grafting can be an option. New developments, include treatment with anxiolytic lasers, laser technology with ultrafine excision/ablation properties avoiding coagulation (Picosecond infrared laser, PIRL), or techniques of tissue engineering. However, despite the promising results by in vitro experiments, animal studies and first clinical trials, the step into clinical routine application has yet to be taken.
KW - Cicatrix
KW - Humans
KW - Otolaryngology
KW - Vocal Cords
KW - Voice Disorders
U2 - 10.1007/s00405-013-2498-9
DO - 10.1007/s00405-013-2498-9
M3 - SCORING: Journal article
C2 - 23605306
VL - 270
SP - 2491
EP - 2507
JO - EUR ARCH OTO-RHINO-L
JF - EUR ARCH OTO-RHINO-L
SN - 0937-4477
IS - 9
ER -