‘Mini-Microsuture Technique’ for Phonosurgery: A New Simplified Method

Abstract

Introduction: Phonomicrolaryngeal surgery involves the surgical treatment of benign disorders of the vocal folds. Postoperative scar tissue in vocal fold mucosa is undesired because mucosal hypodynamia may lead to prolonged impairment in voice quality. This study aims to present and share the outcomes of a new endolaryngeal suture technique. Methods: This study consists of patients who underwent vocal fold surgery followed by endolaryngeal microscopic suturation with a technique that we call the “mini-microsuture technique” between January 2018-December 2019. Videolaryngoscopic images were examined to observe the tissue healing process (suture elimination time, mucosal scar status, and wave pattern) at the first and the fourth week postoperatively. Results: A retrospective analysis was made in 144 (57 males (39.5%) and 87 females (60.5%)) patients who underwent phonomicrosurgery with “Mini-microsuture technique.” Mean age was 40.61 ± 13.54 (10-78) years. There were multiple pathological lesions in 41.66% (n: 60) of our patients, and 58.33% (n: 84) of them had single-lesion. 63.88% (n: 92) of the patients had bilateral vocal fold lesions where 36.22% (n: 52) of the patients had pathology in one vocal fold. Conclusions: The “mini-microsuture technique” is an easy and functional procedure that can be performed by a single surgeon under microscopy, which minimizes tissue trauma, prevents mucosal hypodynamia, and provides a better anatomical structure postoperatively for a symmetrical vibration. The technique does not significantly prolong operation time when mastered and is a cost-effective method in which surgery which can be concluded using a single suture material.

Mucosal Bridge Reconstruction: A Novel Approach for the Vocal Fold Mucosal Bridge

“…The atrophic mucosa underlying the sulcus base was prepared and excised while preserving the vocal ligament. Mini-microsuture technique 15 using 8/0 vicryl was used to suture the medial and lateral edges of the bridge to the mucosa until it was observed that no mucosal gap was left (Supplemental Video 1 and Figures 1 and 2). Afterward, 10 cc blood was drawn from the patient to harvest autologous platelet-rich plasma, which was applied submucosally to facilitate mucosal healing and the operation was ended.…”