Recurrence of benign phonotraumatic vocal fold lesions after microlaryngoscopy.

Abstract

To determine recurrence rates for benign phonotraumatic vocal fold lesions after microlaryngoscopic surgery. Retrospective review. Records of adults who underwent microlaryngoscopy between 2006 and 2017 for vocal fold cysts, midfold masses, polyps, pseudocysts, sulcus vocalis (Ford type 3), and varices were reviewed for demographics, medical history, treatment, and lesion recurrence. Patients operated for nonphonotraumatic lesions (e.g., granuloma, keratosis/leukoplakia, papilloma) were excluded. Stroboscopic examinations were re-reviewed to confirm diagnosis and outcome. Five hundred ten adults (223 male:287 female; mean age 40.3 ± 14.9 years) were included. Overall, 62 of 510 (12.2%) recurred (median time to recurrence: 70.0 months). Of these, 44 (71.0%) recurred to the same lesion type and 49 (79.0%) to the same side. Recurrence rates by initial lesion type were as follows: cysts, two of 92 (2.2%); midfold masses, four of 18 (22.2%); polyps, 25 of 235 (10.6%); pseudocysts, 30 of 145 (20.7%); sulcus vocalis, one of 18 (5.6%); and varices, zero of two (0%) (χ 2 = 28.7, degrees of freedom [df] = 5, P < 0.001). No significant difference in recurrence existed between males (21 of 223, 9.4%) and females (41 of 287, 14.3%). However, young adults (17 of 86, 19.8%) had significantly higher recurrence rates compared to middle-aged (12 of 155, 7.7%) and older adults (3/60, 5.0%) (χ 2 = 9.5, df = 3, P = 0.023). Of 62 recurrences, 18 were re-operated and four re-recurred. Benign phonotraumatic vocal fold lesions recur at variable rates. This variation suggests pathophysiologic differences between categories that may not be entirely explained by behavioral factors. 4 Laryngoscope, 130: 1989-1995, 2020.