Artikel
Genesis, classification and objectivation of vascular changes of vocal folds
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Autoren
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Susanne Voigt-Zimmermann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
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Christoph Arens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| Veröffentlicht: | 7. September 2016 |
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Gliederung
Text
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
- 1.
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- 2.
- Arens C, Betz C, Kraft M, Voigt-Zimmermann S. Narrow band imaging for early diagnosis of epithelial dysplasias and microinvasive tumors in the upper aerodigestive tract. HNO. 2016;64(1):19-26.
- 3.
- Voigt-Zimmermann S, Arens C. Vascular lesions of vocal folds - Part 1: horizontal vascular lesions. Laryngorhinootologie. 2014;93(12):819-30.
- 4.
- Schossee A, Voigt-Zimmermann S, Kropf S, Arens C. Evaluation of a Classification Model of Horizontal Vascular Lesions of the Vocal Folds. Laryngorhinootologie. 2016;95(4):245-50.
- 5.
- Pliske G, Voigt-Zimmermann S, Glaßer S, Arens C. Objective quantification of the vocal fold vascular pattern: comparison of narrow band imaging and white light endoscopy. Eur Arch Otorhinolaryngol. 2016;273(9):2599-605.
- 6.
- Arens C, Glanz H, Voigt-Zimmermann S. Vascular Lesions of Vocal Folds - Part 2: Perpendicular Vascular Lesions. Laryngorhinootologie. 2015;94(11):738-44.
- 7.
- Arens C, Voigt-Zimmermann S. Contact endoscopy of the vocal folds in combination with narrow band imaging (compact endoscopy). Laryngorhinootologie. 2015;94(3):150-2.
