Contribution to therapy of dysphonia plica ventricularis

Abstract

Excision of the hypertrophic ventricular folds was performed in 35 patients by means of laryngomicroscopy. In most of our patients this therapy promptly resulted in a clear voice. Correlating the laryngomicroscopic finding and the histological picture we were able to classify hypertrophy of the ventricular folds into three stages, each of which presents with a characteristical clinical and histological picture and thus requires approapriate therapy. In Stage I the histological changes are reversible and conservative phoniatric therapy leads to success relatively quickly. In the second stage histological changes may also be reversible, and the prolonged and persistent phoniatric therapy leads to success but we prefer microsurgical excision because of the direct effect. In Stage III, however, we found irreversible histological changes in the sense of connective hyperplasia which prompted us to conclude that microsurgical excision alone may lead to regression of the hoarseness.

Ventricular Dysphonia: Clinical Aspects and Therapeutic Options

“…The treatment of Vd consists, first, of voice training (combined with medication and/or psychotherapy). If such measures do not give satisfactory results (because of irreversible pathoanatomical changes in the hypertrophic ventricular folds 24 ), excision of the false vocal folds can be considered in cases with irreversible ventricular hypertrophy and normal true vocal fold function. 7 The 25 patients in the study of Kosokovic and Lenarcic‐Cepelja 4 were not aided by traditional phoniatric therapy.…”

“…It is important that the patient has normally functioning true vocal cords. Kosokovic et al 24 suggested that the therapy of Vd is based on the degree of false vocal fold hypertrophy. The first stage involves inflammatory alterations with soft and elastic hypertrophy at the anterior one‐third of the fold.…”

Treatment of Ventricular Dysphonia With Botulinum Toxin

“…Stage III hypertrophy is considered to be unlikely to completely resolve even with aggressive speech therapy as the histologic changes appear to be permanent 1 . Muscular hypertrophy within the false cords in patients with ventricular dysphonia has not been found 1,4,5 . Other supraglottic musculature must therefore be responsible for the approximation of the false cords for phonation.…”

“…This structural design, along with the unique qualities of the connective tissue layer, allows the “mucosal wave” seen on stroboscopic images of the vocal folds during phonation. Kosokovic et al 1 found the fundamental frequency of speakers using their false vocal folds as a vibratory source was around 60 Hz, well below normal for male or female speakers.…”

Características supraglóticas de idosos: relações com a função de deglutição

“…PINHO et al, 1999;BLOCH;BEHRMAN, 2001;STAGER et al, 2003;JAISWAL;FINNEGAN, 2007;ZHENG et al, 2009;STAGER;BIELAMOWICZ, 2010). Tal comportamento pode causar a hipertrofia do músculo tireoaritenoide e o consequente aumento de volume das pregas vestibulares (KOSOKOVIĆ et al, 1977;VON DOERSTEN et al, 1992).…”