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      Comparação entre a telelaringoscopia e a laringoscopia de suspensão no diagnóstico das lesões benignas das pregas vocais Translated title: Comparison between telelaryngoscopy and suspension laryngoscopy in the diagnosis of benign vocal fold lesions

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          Abstract

          O correto diagnóstico das lesões benignas da laringe ainda causa dúvida em laringologistas experientes, apesar dos avanços diagnósticos. OBJETIVO: O objetivo desse estudo foi comparar a telelaringoscopia (pré-operatória) com a laringoscopia de suspensão (intra-operatória) no diagnóstico das lesões benignas das pregas vocais. MATERIAL E MÉTODO: Foi realizado um estudo retrospectivo através da análise de 79 prontuários de pacientes acompanhados em um hospital universitário. Em todos os prontuários havia pelo menos uma hipótese diagnóstica ambulatorial sugerida pela telelaringoscopia, que posteriormente foi comparada aos achados intra-operatórios da laringoscopia de suspensão. RESULTADOS: Quase dois terços dos pacientes eram do gênero feminino, com idade variando de 12 aos 66 anos (média de 37 anos). Dos 79 pacientes estudados, foram diagnosticadas 95 lesões com a telelaringoscopia e 124 com a laringoscopia de suspensão. A lesão benigna mais freqüente foi pólipo vocal em ambos os métodos. Em 64,5% dos casos, o diagnóstico das lesões feito no ambulatório foi o mesmo dos achados cirúrgicos. CONCLUSÃO: O laringologista deve estar preparado para alterar seu planejamento cirúrgico e abordagens terapêuticas devido às mudanças diagnósticas que ocorrem no intra-operatório.

          Translated abstract

          Proper diagnosis of laryngeal benign lesions still brings doubts among experienced laryngologists, despite current diagnostic progress. AIM: the goal of this study was to compare telelaryngoscopy (preoperative) with suspension laryngoscopy (intraoperative) on the diagnosis of vocal fold benign lesions. MATERIALS AND METHODS: We carried out a restrospective study analyzing 79 charts from patients followed up in a University Hospital. In all the charts there was at least diagnostic hypothesis suggested by telelaryngoscopy, which was later on compared to intraoperative findings of suspension laryngoscopy. RESULTS: Almost two-thirds of the patients were females, with ages varying between 12 and 66 years (mean of 37 years). Of the 79 patients studied, we diagnosed 95 lesions with telelaryngoscopy and 124 with suspension laryngoscopy. The most frequently found benign lesion was the vocal polyp in both methods. In 64.5% of the cases the diagnosis of the lesions in the outpatient ward was the same as those in the surgical findings. CONCLUSION: Laryngologists must be prepared to alter their surgical planning and treatment approaches because of diagnostic changes that may happen during surgery.

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          Consistency of the preoperative and intraoperative diagnosis of benign vocal fold lesions.

          The purpose of this retrospective study was to compare the preoperative and intraoperative diagnosis of benign vocal fold lesions for consistency. The diagnosis was made in 221 consecutive patients with benign vocal fold lesions for which a microlaryngoscopy was carried out in a general ENT-clinic. The preoperative diagnosis was obtained by both white halogen and stroboscopic light. The intraoperative diagnosis was obtained by direct microscopic visualization and palpation of the vocal folds. In 36% of the patients, the preoperative diagnosis was changed intraoperatively. In 31% of the patients, a lesion was missed at the preoperative examination and a lesion was diagnosed only during microlaryngoscopy. Bilateral lesions were found in 53% of the patients preoperatively, and in 82% of the patients intraoperatively. Specially intracordal lesions constituted a diagnostic pitfall. Because the preoperative and intraoperative diagnosis often differed, both the patients and the ENT-surgeon must keep an open mind about what may need to be done at surgery.
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            The history of laryngology: a centennial celebration.

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              Epidermoid cysts of the vocal cords.

              Fifty-three cases of intracordal epidermoid cysts diagnosed, treated and followed from 1972 to 1981 are presented. In the clinical evaluation, special attention must be paid to the type of dysphonia and morphology of the vocal cords at indirect laryngoscopy. The epidermoid cyst is not easily visualized and the examiner must take into account signs like "monochorditis," slight bulging, unilateral nodule and diminished or abolished vibrations of one of the cords at stroboscopy. Microsurgical excision followed by voice therapy is the recommended treatment. The pathogenesis of these cysts is still speculative. Two theories are discussed: the traumatic theory and the dysembryoplastic theory.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rboto
                Revista Brasileira de Otorrinolaringologia
                Rev. Bras. Otorrinolaringol.
                ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (São Paulo )
                0034-7299
                December 2008
                : 74
                : 6
                : 869-875
                Affiliations
                [1 ] Universidade Federal de São Paulo Brazil
                [2 ] Universidade Federal de São Paulo Brazil
                [3 ] Universidade Federal de São Paulo Brazil
                Article
                S0034-72992008000600009
                10.1590/S0034-72992008000600009
                2910cbc8-c45b-4d55-ad4e-9984330f6995

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0034-7299&lng=en
                Categories
                OTORHINOLARYNGOLOGY

                Otolaryngology
                surgery,vocal cords,diagnosis,cirurgia,cordas vocais,diagnóstico
                Otolaryngology
                surgery, vocal cords, diagnosis, cirurgia, cordas vocais, diagnóstico

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