A Comprehensive Analysis of Benign Vocal Fold Lesions Causing Hoarseness of Voice and Our Experience with Cold Knife Endolaryngeal Surgery in a Tertiary Healthcare Centre
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Benign vocal fold lesions (BVFL) frequently affect the general population and cause significant hoarseness by interfering with daily communication. Healthcare for low income groups in India is all about affordability and availability without giving up on quality and providing maximum satisfaction. (1) To analyse over a period of 4 years, the demographics, clinical profile, diagnostics and management options of BVFL. (2) To assess the diagnostic potential of rigid laryngoscopy in diagnosing these lesions. (3) Cold knife endolaryngeal surgery as a cost effective, satisfactory and efficient treatment modality to tackle majority of these BVFL. A prospective cross sectional study over a period of 4 years from 2013 to 2017. 114 patients presenting with hoarseness of voice were evaluated by indirect laryngoscopy followed by video laryngoscopy and stroboscopy in the department of ENT, MYH Hospital Indore (M.P.). Male:female ratio of 1.59:1 with male predominance (61.4%) and maximum incidence in the third decade (32%). All cases presented with hoarseness (100%) while vocal fatigue (63%) was the most common associated complaint followed by foreign body sensation (60%). Housewives (32%) were most commonly involved non professional group while teachers (13%) constituted the most common group of professionals. Laryngitis (26%) involving bilateral vocal folds diffusely was the most common finding followed by vocal fold sulcus (18%) and vocal fold cysts (14%). The duration of symptom was 6 months to 1 year in 52% patients. The positive predictive value for rigid laryngoscopy was 100% for vocal nodules, arytenoid granulomas and anterior glottis web. Out of 114 patients, 66 patients improved on conservative management while 48 patients underwent cold knife endolaryngeal surgery. As per the GRBAS scale to assess the post therapeutic prognosis, all had good outcome of voice with only two recurrences due to patient non compliance. In this rapidly evolving era of sophisticated lasers which is a costly affair that requires skilled personnel and safety precautions, the prime goal in a government run setup has always been to provide affordable and quality healthcare to the common man. Cold knife endolaryngeal surgery is a simple, cost effective and efficient way to tackle most of these lesions and hence helps in achieving this goal.
KeywordsBenign vocal fold lesions (BVFL) Hoarseness Cold knife endolaryngeal surgery (CKELS)
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Human and Animal Rights
This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 3.Maran AGD (1982) Voice problems, logan turners diseases of ENT. Laryngology 1:372Google Scholar
- 4.Bastian Robert W (2005) Benign vocal fold mucosal disorders Cummings otolaryngology head and neck surgery, vol 3, 4th edn. Mosby Elsevier, Philadelphia, p 2150Google Scholar
- 10.Singhal P, Bhandari A, Chouhan M, Sharma MP, Sharma S (2009) Benign tumors of the larynx: a clinical study of 50 cases. IJLO 61(1):26–30Google Scholar
- 14.Parikh N (1991) Aetiology study of 100 cases of hoarseness of voice. Indian J Otolaryngol Head Neck Surg 43(2):71–73Google Scholar
- 18.Saudi S (2013) Benign lesions of the vocal cards in different ages: prospective study of 60 cases. J Med Sci Technol 2(3):130–134Google Scholar
- 23.Sharma M, Kumar S, Goel M, Angral S, Kapoor MA (2015) Clinical study of benign lesions of larynx. Int J Oral Health Med Res 2(2):22–28Google Scholar