Microflap Surgery

Conventional surgery for removal of polyps and cysts involves holding them and amputating them at there base. This results in the loss of a certain amount of normal tissue. With better understanding of the importance of the layered microstructure of the vocal folds, laryngologists try to preserve as much normal tissue as possible. This is achieved by "Microflap Surgery" in which a microscopic flap is elevated of the first layer and then the lesion is precisely dissected out. The first layer (epithelium) is then draped back in position. This technique can be used for vocal fold polyps, vocal cysts ,early vocal carcinoma or precancerous lesions.

Vocal fold cysts and polyps usually need surgical excision unlike vocal fold nodules which respond very well with voice therapy.

Vocal Fold Sulcus

Sulcus vocalis is an absence of the second layer of the vocal fold called Superficial Lamina Propria. Occasionally the third layer (Vocal ligament) may be absent in places.

This leads to the formation of a gutter-like depression which hampers vibration of the vocal folds. Voice therapy may not give adequate benefit and surgery to recreate this layer may be performed. Fat is a common substance used to create an artificial lamina propria, however, surgeries for sulcus do not give a very good vocal outcome and the patient must be forewarned of this.

Vocal Fold Cyst: Video

Vocal Fold Polyp: Video 1

Vocal Fold Polyp: Video 2