Use of pulsed dye laser treatments in patients with vocal fold mucosal bridges with sulcus vocalis-our experience of five cases

Abstract

Larger and thicker mucosal bridges are usually associated with severe dysphonia, surgical excision is the currently preferred treatment.

Surgical excision of mucosal bridges may decrease vocal fold bulk and result in subsequent postoperative glottal incompetence.

PDL can make a cleavage plane between the epithelium and the superficial lamina propria by denaturing the anchoring fibers of lamina lucida of the basement membrane, and this plane allows en-bloc and easy peeling of the medial epithelium of the mucosal bridge. In addition, epithelium overlying the sulcus can be vapourized or denatured by direct contact with the PDL fibres. Therefore, approximation between the de-epithelized mucosal bridge and the PDL-treated sulcus bed can be accomplished easily with preservation of the lamina propria of vocal folds.

PDL may induce additional restoration of lamina propria by physiologic tissue remodeling on the accompanying sulcus vocalis with mucosal bridge

PDL glottoplasty with the PDL-assisted mucosal bridge undermining technique can be an effective and safe technique, and be advised for obviating the loss of bulk due to surgical resection of the mucosal bridge.

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