An Island Flap Technique for Laryngeal Intracordal Mucous Retention Cysts

Introduction: mucous retention cysts are a subtype of intracordal vocal cysts that may occur spontaneously or may be associated with poor vocal hygiene, and which require optimal treatment. the objective of this study was to present a new laser-assisted microsurgery technique for treating intracordal mucous retention cysts and to describe the final outcomes. materials and methods: in this prospective study, we assessed the pre-operative and post-operative acoustic analysis, maximum phonation time (mpt), and voice handicap index (vhi) of four patients with a diagnosis of mucous retention cyst. the island flap technique was applied to all patients without any complications. in this procedure, we favored the super-pulse mode using a 2-w power co2 laser to remove the medial wall of the cyst, before clearing away the lateral wall margins of the cyst using repeat-pulse mode and a 2-w power co2 laser. indeed, we maintained the underlying epithelium and lamina propria, including the island flap attached to the vocal ligament. results: there was a statistically significant improvement in the mpt (pre-op,11.05 s; post-op,15.85 s; p=0.002) and the vhi (pre-operative, 72/120; post-operative,27/120; p=0.001) in all patients. moreover, jitter and shimmer were refined after surgery, but there was no statistically significant relationship between pre-operative and post-operative data (p=0.071) (p=0.622). in the follow-up period (median, 150 days), there was no report of recurrence or mucosal stiffness. conclusion: the island flap procedure in association with co2 laser microsurgery appears to be a safe and effective treatment option for intracordal mucous retention cysts, but needs further investigation to allow comparison with other methods.