Speciality
Spotlight

 




 


Endoscopy


 

    





Phonomicrosurgery

    


  • Steven
    M Zeitels, MD

    Phonomicrosurgery I : Principles and Equipment

    The Origin and Development of Endoscopic Laryngeal
    Surgery


    From the Department of Otology and
    Laryngology, Harvard Medical School; and the
    Division of Laryngology, Massachusetts Eye and Ear
    Infirmary, Boston, Massachusetts

    The Otolaryngologic
    Clinics of North America

    Volume
    33, Number 5, October 2000, Pg. 1047-1062

        

    PHONOMICROSURGERY-

      

    Phonomicrosurgery
    is a means of maximally preserving the layered
    microstructure of the vocal fold, that is, the
    epithelium and lamina propria.

       

    Tissue
    Dissection : Laser Versus Cold Instruments.


    Unlike the
    laser, cold instruments provide tactile
    proprioception during delicate microdissection.

      

    Infusion into the superficial lamina propria is
    often helpful, whether a laser or cold instruments
    are used.

      

    Precise
    tangential dissection within the superficial lamina
    propria [i.e., subepithelial cyst dissection] is
    better accomplished with cold instruments.

      

    Cold
    instruments facilitate maximal preservation of the
    layered microstructure [lamina propria and
    epithelium] of the vocal folds.

       

    The CO2 laser is typically used for vocal
    fold surgery and enhances cold fd  
    instruments when the pathologic condition is
    vascular or is too large.

       

    The Rationales of Phonomicrosurgery.


    Phonomicrosurgical
    procedures are designed to improve aerodynamic
    efficiency and vocal quality by creating a smooth
    vocal fold edge that is not excavated with overlying
    flexible epithelium.

        

    There is a little difficulty in the growth
    and regeneration of normal epithelium, as occurs
    after a cordectomy that is left to heal secondarily.

         

    The
    subepithelial infusion of saline ad epinephrine into
    the superficial lamina propria has further enhanced
    the precision of microlaryngoscopic vocal fold
    surgery with the use of both laser and cold
    instruments.

       

    The author has used cold-instrument epithelial
    incision as a standard approach for the management
    of such pathologic conditions as cysts, epithelial
    atypia, and cancer.

       

    During the last 4 years, this approach has been
    extended to the management of nodules, polyps,
    ectasias, and varices, so a subepithelial resection
    of these traumatic lesions has become standard.

        

    Phonomicrosurgery has emerged as a physiologically
    based approach for benign and malignant disease.

        



 



 

 

Speciality Spotlight

 

 
Endoscopy
 

    

Phonomicrosurgery
    

  • Steven M Zeitels, MD
    Phonomicrosurgery I : Principles and Equipment
    The Origin and Development of Endoscopic Laryngeal Surgery

    From the Department of Otology and Laryngology, Harvard Medical School; and the Division of Laryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
    The Otolaryngologic Clinics of North America
    Volume 33, Number 5, October 2000, Pg. 1047-1062
        
    PHONOMICROSURGERY-
      
    Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria.
       
    Tissue Dissection : Laser Versus Cold Instruments.
    Unlike the laser, cold instruments provide tactile proprioception during delicate microdissection.
      
    Infusion into the superficial lamina propria is often helpful, whether a laser or cold instruments are used.
      
    Precise tangential dissection within the superficial lamina propria [i.e., subepithelial cyst dissection] is better accomplished with cold instruments.
      
    Cold instruments facilitate maximal preservation of the layered microstructure [lamina propria and epithelium] of the vocal folds.
       
    The CO2 laser is typically used for vocal fold surgery and enhances cold fd   instruments when the pathologic condition is vascular or is too large.
       
    The Rationales of Phonomicrosurgery.
    Phonomicrosurgical procedures are designed to improve aerodynamic efficiency and vocal quality by creating a smooth vocal fold edge that is not excavated with overlying flexible epithelium.
        
    There is a little difficulty in the growth and regeneration of normal epithelium, as occurs after a cordectomy that is left to heal secondarily.
         
    The subepithelial infusion of saline ad epinephrine into the superficial lamina propria has further enhanced the precision of microlaryngoscopic vocal fold surgery with the use of both laser and cold instruments.
       
    The author has used cold-instrument epithelial incision as a standard approach for the management of such pathologic conditions as cysts, epithelial atypia, and cancer.
       
    During the last 4 years, this approach has been extended to the management of nodules, polyps, ectasias, and varices, so a subepithelial resection of these traumatic lesions has become standard.
        
    Phonomicrosurgery has emerged as a physiologically based approach for benign and malignant disease.
        

 

 

By |2022-07-20T16:41:55+00:00July 20, 2022|Uncategorized|Comments Off on Endoscopy

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