Videolaryngostroboscopy following frontolateral laryngectomy with sternohyoid flap

Abstract

Objectives: To analyze videostroboscopic findings in patients who underwent vertical frontolateral laryngectomy with reconstruction with sternohyoid muscle flap. Methods: A retrospective study was conducted to evaluate 21 patients staged as T1b and T2 glottic tumors. A videostroboscopic protocol was applied. Three observers analyzed the recorded data. Fisher Exact Test was applied. Results: The glottic closure: complete in 15 and irregular vocal gaps in 6. The site of vibration: glottic in 10, supraglottic in 7 and mixed in 4. The amplitude: normal in 4, slightly diminished in 9 preserved sides, moderately or severely diminished in 16 and absent in 5 reconstructed sides. The mucosa wave vibratory pattern: always totally present in 15 preserved and in 5 reconstructed sides; normal or slightly diminished in the preserved vocal folds and moderately or severely diminished in the reconstructed ones; the reconstructed vocal folds had nonvibrating portion in 5 cases. The movement extension of the preserved side: larger than the other in 8 and similar in 13. The symmetry: regular in 18. The periodicity: always/generally regular in 9. There was supraglottic hyperadduction in 16. The mucosal appearance: normal in 15 and humid in 6. The epiglottis: straight in 14 cases and in crescent in 7. Mucus formation: in one patient in the posterior vibratory portion. Conclusion: Videolaryngostroboscopy allowed thorough evaluation the vibratory pattern of the vocal folds in 52.4%. The supraglottic hyperadduction component and the supraglottic vocal source presented difficulty for this evaluation. The site of vibration was glottic in 47.6%, supraglottic 33.3%, and mixed in 19.1%.