Microsurgical Extirpation of Intracordal Cyst with a Microflap Technique

미세피판기법을 이용한 성대낭종제거술

  • Ahn, Jungmin (Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Choi, Ji-Eun (Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Lee, Dong Kun (Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine) ;
  • Jang, Jeon Yeob (Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Son, Young-Ik (Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center)
  • 안정민 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 최지은 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 이동근 (인제대학교백병원 의과대학 이비인후과학교실) ;
  • 장전엽 (부산대학교병원 의과대학 이비인후과학교실) ;
  • 손영익 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실)
  • Received : 2015.12.18
  • Accepted : 2015.12.31
  • Published : 2016.06.30

Abstract

Background and Objectives : Microsurgical resection of intracordal cysts is technically difficult and challenging because the wall of cysts may be tightly attached to underlying vocal ligament and/or overlying epithelium, and therefore their thin wall will easily rupture during surgical dissection. We aimed to evaluate the voice outcomes of standard microflap subepithelial resection and the recurrence rate depending on the intraoperative rupturing of the cyst. Materials and Methods : Medical records of Samsung Medical Center, Seoul, Korea, were reviewed for sixty-four consecutive patients who received surgical resection of vocal cyst using microflap subepithelial dissection technique between the year 2004 and 2013. Meticulous dissection was performed to completely remove the cyst wall while preserving the mucosa and the lamina propria as much as possible. Voice outcomes and recurrence rates were compared according to the type, size and the intraoperative rupture of cyst. Results : Presence or absence of cyst rupture was clearly described in the operation records of 41 patients. Intraoperative rupture of the cyst occurred in 32 of 41 (78%) patients. The recurrence was detected in 5 of 64 (7.8%) total cases and 4 of 32 (12.5%) cases of ruptured cyst, but not in 9 cases of intact extirpation. Rupture was more common in case of mucous retention cyst compared with epidermoid cyst (p=0.036). Subjective and objective voice parameters were measured at before and 3 months after surgery, which improved regardless of the cyst rupture. Conclusion : Although complete microsurgical extirpation of intracordal cyst while keeping the cyst wall intact is technically difficult, meticulous dissection with maximal preservation of surrounding tissue may warrant the improvement of voice outcomes.

Keywords

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