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A Videolaryngoscopic Study

Noemi Grigoletto De Biase, PhD; Paulo Augusto de Lima Pontes, PhD

Arch Otolaryngol Head Neck Surg. 2008;134(7):720-724.

Objective  To analyze and compare the incidence and visual characteristics of blood vessels on the superior surface of vocal folds with polyps, nodules, and minimal structural alterations (ie, sulci, cysts, and mucosal bridges).

Design  Cross-sectional study.

Setting  Academic research.

Patients  A total of 280 videolaryngoscopic images were randomly selected and classified into the following 4 groups of 70 patients each: the vocal nodule (VN) group, the polyp group, the minimal structural alterations (MSA) group, and the control group.

Main Outcome Measures  Laryngoscopic images were assessed for visible blood vessels and for the orientation and characteristics of the vessels. Isolated ectasias with clear boundaries were excluded.

Results  The highest incidence of visible vessels was observed in the MSA group (91.4%), followed by the polyp (77.1%), VN (44.7%), and control (31.4%) groups. Longitudinal and transverse vessels were found more frequently in the MSA (74.3% and 37.1%) and polyp (65.7% and 22.9%) groups than in the VN (34.3% and 12.9%) and control (25.7% and 5.7%) groups. Tangled vessels were found only in the MSA group (8.6%). Abrupt changes in the caliber of the vessels and sinuous vessels were observed only in the polyp (21.4% and 5.7%) and MSA (61.4% and 27.1%) groups.

Conclusions  The main differences in the incidence and characteristics of visible blood vessels occurred between 2 pairs of groups: MSA-polyp and VN-control. The incidence was significantly higher in the MSA group than in the polyp group, and the incidence in both the MSA group and the polyp group was also significantly higher than that in the VN and control groups. The greatest variations were found in the MSA group, including the presence of tangled blood vessels (which was observed only in this group).

Author Affiliations: Department of Speech Language Pathology, Pontifical Catholic University of São Paulo (Dr De Biase), Larynx Institute (Drs De Biase and Pontes), and Department of Otorhinolaryngology–Head and Neck Surgery, Federal University of São Paulo/Paulista School of Medicine (Drs De Biase and Pontes), São Paulo, Brazil.