Presentation

entsociety.co.za

Presentation

A Most Challenging Case

Peak Woo MD

Clinical Professor

Mt. Sinai School of Medicine

New York, NY

Presentation at: ENT/SAHNOS/SAA/SASLAH CONGRESS

SOUTH AFRICA, October 2010

AG

Treatment by operative removal of polyp

followed by 3x office PDL as laser PDL

scar protocol

Operative injection laryngoplasty with

Alloderm at same setting

Case Post radiation dysphonia

Pre

Post

1/06

75 yr old male presented

in 2006 with worsening

dysphonia

1980’s 1980 s had radiation

therapy for laryngeal

cancer

Now has socially

unacceptable voice

Perceptual: G3R3B2S3

PT=3-4 PT=3 4 sec

VHI 77

Case AG

Case Post radiation 2006: Treated

by PDL

8/06

5/06

11/06

Revisit 8/06 8 mo post

Breathy dysphonia

Lack of projection

Not improved with

brief therapy

PT 5 seconds

VHI 58

1


Mini-thyrotomy Mini thyrotomy with

sheet Alloderm

FU 11/07 voice

holding up well

VHI 46

Treatment

Show video

PRE PO-2wk

PO-2mo

PO-6mo

AG Did well for 2 yr

Now 79

Has voice loss with

loss in volume

Wants more

Pre and Post operative

Post

Mini-thyrotomy Mini thyrotomy with

sheet Alloderm graft

2


Animal studies Mini-thyrotomy Mini thyrotomy and elevation

Mini-thyrotomy Mini thyrotomy with sheet Alloderm Insertion and monitoring

Implant in place Mini-thyrotoMy

Mini thyrotoMy with allograft

First proposed by Gray

For soft tissue augmentation vocal fold

margin

Correction of vocal fold soft tissue

defects due to:

Scar

Bowing and atrophy

Vocal fold paralysis

3


What to do?

Inject-able, Inject able, office? OR?

Bilateral medialization

Wait?

4

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