Neurinoma of the vocal fold is not common. A 43-year-old female with neurinoma of the left vocal fold was treated by microlaryngeal surgery. Clinical observation using laryngostrobovideography and CT revealed a smooth mass localized in the left vocal fold. The tumor was successfully removed under general anesthesia by microlaryngeal surgery. We applied the fibrin-glue (Tisseel(R)) on the surgical wound of the vocal fold to avoid post-operative scar.Postoperative wound healing of the vocal fold was excellent in this case . Her phonatory function was satisfactory and no tumor recurrence have been noted after surgery . In this case, the fibrin glue might have good effect on the wound healing of the vocal fold.
It is very important to maintain the adequate stiffness of the vocal folds on phonosurgery .When the surgical procedure reaches to the deep layer of the lamina propria or the vocalis muscle, dysphonia tends to occur because of scar formation.Chronic experiments using canine larynges were performed to clarify the usefullness of the fibrin tissue adhesive (Tisseel-kit (R)) for the wound healing.After removing the mocosa of 2 mm in depth on the bilateral side of the canine vocal folds, the fibrin tissue adhesive was applied to the one side.After 1,2,3,and 5 weeks, following procedures were carried out : (1) laryngomicroscopic observation of the vocal folds (2)resection of the larynges (3) recording of the vocal fold vibration with an ultra high speed camera (4) analysis of the vocal fold vibration by using a film motion analizer (5) histopathological study.The results were summarized as follows : (1) Good epithelization was observed on both sides laryngomicroscopically.(2) Better vibration of the vocal fold was observed on the adhesive applied side. (3) In contrast to marked fibrosis on the non-applied side, loose fibrosis and granulomatous lesion were observed on the applied side.Our results suggest the fibrin tissue adhesive might have good effect on the wound healing of the vocal fold.
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