Article
Genesis, classification and objectivation of vascular changes of vocal folds
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Published: | September 7, 2016 |
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Outline
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Vascular changes of vocal folds can be detected early, assessed and treated specifically with improved endoscopic tools, such as HD- and chip-on-the-tip endoscopy, as well as Narrow Band Imaging (NBI) [1].
Vascular changes mainly develop in two directions: longitudinally and perpendicularly [2]. Horizontal vascular changes, such as ectasia, meandering vessels or changes of direction, are primarily indicative of functional failures during phonation. Lateral differences of vibration features of vocal folds and the mucosal wave, e.g. amplitude, regularity or symmetry, are also indications of cervicogenic problems [3].
The early detection and description of such longitudinal vascular changes through regular use of modern endoscopic procedures allow a targeted therapy, e.g. functional voice therapy or manual therapy, to prevent further vascular diseases of the vocal folds, such as vocal fold varices, teleangiectatic vocal fold polyps, or hemorrhages. Incipient benign vascular changes can be classified. We tested such a classification model successfully [4]. In addition, we were able to use an objective method that quantifies such changes [5].
Subepithelial vessel loops are important indications of either HPV-induced recurrent respiratory papillomatosis or precancerous or cancerous diseases, in which they develop after initial induction by a subepithelial growth stimulus [6]. The additional use of contact endoscopy in combination with NBI in direct endoscopy allows a precise assessment of the degree of vessel loop formation and an exact intraoperative determination of the cut edge [7].
References
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