Iatrogenic scarring of the vocal folds after phonosurgery for benign lesions. A descriptive study of 108 patients.

Objectives: Patients with iatrogenic scarring of the vocal folds can present with a spectrum of dysphonia ranging from slight hoarseness to very severe dysphonia. In this paper we will describe the clinical and stroboscopic presentation of VFIS, and discuss the possibility of identifying the factors favouring such lesions.

Study Design: A retrospective chart review from 2002 to 2011.

Methods: A retrospective chart analysis of patients complaining of no improvement in (or worsening of) the quality of their voices after primary phono-surgery for benign lesions of the vocal folds.

Results: Our series consisted of 108 patients (107 women and 1 man) with a mean age of 38.1. The initial complaint was always of no improvement in (or worsening of) voice quality more than three months after phonosurgery for benign vocal fold lesions. The overall grade of dysphonia according to Hirano's scale was 1.79 (n = 84). Voice evaluation showed forced phonation in 29% of the patients, sharp breaks or irregular vibration in 31%. The appearance of the larynx in normal and stroboscopic light is presented. The results of this study do not allow the factors favouring the occurrence of iatrogenic scars to be formally identified since in 75% of cases, the diagnosis of the initial lesion or the operative procedure used was unknown. However, the link between the initial lesion, the operating technique and the occurrence of scarring is discussed for the remaining 25%.