Reliability of nasofibroscopy for the evaluation of adenoid hypertrophy and its correlation with clinical symptoms.

OBJECTIVE: To analyze the reliability of estimating the percentage of rhinopharyngeal obstruction by the adenoid using nasofibroscopy and its correlation with clinical symptoms. METHODS: Cross-sectional observational study was conducted, involving 80 patients between 4 and 14 years old, recruited from Santa Casa of São Paulo general otorhinolaryngology outpatient service during the years of 2020 and 2021. All patients underwent nasal endoscopy examination, and the recorded videos were randomly assigned to four evaluators in two different sessions, with a minimum interval of 1 month. The evaluators estimated the percentage of rhinopharyngeal obstruction caused by the adenoid. Intra- and inter-evaluator correlations were established by comparing the reports from each evaluator. The data were compared to the Pro Image J Software report, that also estimates a percentage of obstruction by computer graphics. To correlate the grading of obstruction with clinical symptoms, all patients completed the OSA (Obstructive Sleep Apnea) 18 questionnaire, a validated tool for assessing sleep apnea in children. The questionnaire data were then compared to the average scores assigned by the evaluators. RESULTS: Satisfactory intra- and inter-rater correlations were observed, and the results were consistent with the Pro Image J Software. However, no correlation was found between the percentage of obstruction and the severity of clinical symptoms. CONCLUSION: Nasofibroscopy demonstrates good reliability in assessing a percentage of rhinopharyngeal obstruction caused by adenoids. However, there is no correlation between the degree of obstruction of the rhinopharynx and the clinical symptoms.

Dysphonia and Throat Clearing in Singers During the COVID-19 Pandemic in Brazil.

OBJECTIVE: The COVID-19 pandemic in Brazil affected the lives of singers, with negative impacts of the disease on the voice, such as dysphonia and throat clearing. This study aims to evaluate the presence of dysphonia and throat clearing in singers during the COVID-19 pandemic in Brazil. MATERIAL AND METHODS: This is a cross-sectional analytical study with a sample of 154 singers from all over Brazil. Data collection was carried out online, by completing the questionnaire created by the researcher using Google Forms. The following were considered the outcome variables: voice impairment and throat clearing. The bivariate analysis was performed to test the relationship between COVID-19 infection and voice impairment, COVID-19 infection and throat clearing, COVID-19 infection and laryngeal complaints (voice impairment and throat clearing). RESULTS: In this study, the mean age of the singers was 35.8 (Standard deviation = ±10.2 years) and 59.2% were female. Most of them worked as professional singers (81.1%) and had more than 10 years of professional experience (57.4%), mainly singing pop music (85.4%). A total of 62% reported vocal alterations during the COVID-19 infection and 53% had vocal alterations after the infection, with 44.0% reporting the onset of throat clearing after the infection. There was a significant association between COVID-19 infection and having voice impairment (P = 0.03; prevalence ratio - PR: 2.33; CI: 1.04-5.46). An association was observed between the onset of throat clearing and the occurrence of COVID-19 infection (P = 0.001; PR: 9.13; CI: 2.47-64.42). CONCLUSIONS: The results indicated that there is an association between COVID-19 infection and complaints of dysphonia and throat clearing in Brazilian singers. This study demonstrates the importance of guidance to singers infected with COVID-19 by health voice processionals.

Effect of application of fibrin glue on vocal fold healing after surgical manipulation in rabbits.

INTRODUCTION: A challenge in phonosurgery is achieving good vocal quality with minimal vocal fold fibrosis. Fibrin glue can be applied to minimize fibrosis; however, its use in the larynx is based primarily on clinical experience, particularly in extensive lesions. OBJECTIVE: The objective of this study was to evaluate the effect of application of fibrin glue on collagen concentration at the late phase of the healing process after detaching a pedicled flap of the vocal fold cover in rabbits. METHODS: In this prospective animal study, twelve adult male rabbits underwent laryngeal microsurgery, in which an incision was made along the entire length of both vocal folds, followed by extensive mucosal detachment and section of the incision ends. Fibrin glue was applied in the left vocal fold, and the mucosa was repositioned. In the right vocal fold, the mucosa was repositioned without treatment with fibrin glue. After 3-months, the rabbits were euthanized. Histological analyses were performed, and the data collected were subjected to statistical analysis. RESULTS: Vocal folds treated with fibrin glue presented higher collagen concentration in Masson trichrome staining and significantly higher (p < 0.05) collagen concentration in picrosirius red staining compared to control vocal folds. CONCLUSION: Treatment with fibrin glue led to greater vocal fold fibrogenesis in the present study. Nonetheless, further studies are necessary to determine the prophylactic effect of sealants in laryngeal surgeries that require extensive detachment of the vocal fold cover.

Evaluation of the Reflux Symptom Index and the Endolaryngeal Findings Scale after Treatment in Individuals with Laryngopharyngeal Reflux.

Introduction Laryngopharyngeal reflux (LPR) is a prevalent condition in outpatients visiting the otorhinolaryngological clinic, with many controversies regarding its diagnosis and follow-up. Therefore, there is a need for clinical instruments that can diagnose individuals and monitor the results of their treatment. Objective To evaluate the applicability of the scores translated and adapted to Brazilian Portuguese: Reflux Symptom Index (RSI) and Endolaryngeal Reflux Findings Scale (ERFS), as instruments for post-treatment follow-up of LPR. Method A total of 35 individuals with atypical symptoms of gastroesophageal reflux disease and with an objective diagnosis of LPR, confirmed by high digestive endoscopy and 24-hour esophageal pH-metry dual probe test were submitted to the RSI and ERFS questionnaires, used in the pre- and post-treatment of 90 days with a Proton Pump Inhibitor. Result The evaluation of RSI and ERFS in the pre- and post-treatment showed a reduction in the results of the two scores, with a higher drop in the RSI ( p < 0.001) than in the ERFS ( p = 0.014). Although there was an improvement in the values in 23.9% of the individuals in the ERFS, there was no change in the category ( p = 0.057), different from the RSI ( p < 0.001), where there was a 67.4% improvement in values, as well as change in category (score went from positive to negative). There was a correlation between RSI and ERFS, moderate in the pretreatment and strong in the post-treatment. Conclusion The RSI and ERFS scores, when translated and adapted for Brazilian Portuguese and applied simultaneously, can be considered a good tool for post-treatment LPR follow-up.

Vocal tract analysis in patients with vocal fold nodules, clefts and cysts.

UNLABELLED: The supraglottic plan represents an important dimension in vocal production, and its characterization is very important in the evaluation and treatment approach of dysphonic individuals. AIM: To check if certain glottic configurations are related to specific adjustments in the vocal tract. To use nasal and laryngeal fibroscopy to assess the frequency of supraglottic vocal tract adjustments in dysphonic women with nodules, clefts and cysts. METHODS: We assessed 31 dysphonic women, with age ranging between 18 and 45 years, with vocal alteration and a diagnosis of nodules, middle-posterior cleft and cyst, and we carried out a summarized evaluation of the sensory-motor and oral systems and the patients were submitted to video-laryngostroboscopy and nasal and laryngeal fibroscopy. Three distinct groups were selected: patients with bilateral nodules, clefts and cysts, with similar glottic configuration. Their vocal tracts were visually analyzed through exams of nasal and laryngeal fibroscopy, by speech and hearing therapists and otorhinolaryngologists, checking the following parameters: supraglottic constriction, larynx vertical mobility, pharyngeal constriction and tongue mobility. The data was statistically described and treated. RESULTS: During visual analysis we did not find statistically significant differences which would separate the glottic alterations groups. CONCLUSION: There was no correlation between supraglottic tract adjustments with any particular type of glottic alteration. These are individual behaviors that generate adjustments and justify the different vocal qualities in patients with the same type of laryngeal alteration.

Temporal Association Between Respiratory Events and Reflux in Patients With Obstructive Sleep Apnea and Laryngopharyngeal Reflux.

STUDY OBJECTIVES: The aim of the current study was to test the hypothesis that there is a temporal correlation between reflux episodes and respiratory events in patients with laryngopharyngeal reflux and obstructive sleep apnea. METHODS: Adults with clinically diagnosed laryngopharyngeal reflux confirmed by two validated instruments (reflux symptom index ≥ 13 and reflux finding score ≥ 7) and obstructive sleep apnea (OSA) underwent full polysomnography with concomitant and synchronized multichannel intraluminal impedance-pH esophageal monitoring. The apnea-hypopnea and arousal indexes that occurred 15, 30, and 45 minutes before and after each reflux episode were recorded and compared to full-night apnea and hypopnea and arousal index. RESULTS: We studied 27 patients (14 males, age 51.7 ± 9.1 years, body mass index 32.4 ± 4.2 kg/m²) with laryngopharyngeal reflux (reflux symptom index 16 ± 2 and reflux finding score 12 ± 3) and OSA (apnea-hypopnea index = 32.3 ± 28.4 events/h). We evaluated 102 reflux episodes. Almost half of the reflux episodes occurred while awake (43.1%) and only five reflux episodes (4.9%) occurred during an obstructive respiratory event. The apnea and hypopnea and arousal indexes 15, 30, and 45 minutes before and after reflux episodes were lower than full-night apnea and hypopnea and arousal indexes, respectively. CONCLUSIONS: Among patients with well-established laryngopharyngeal reflux and OSA, there is no temporal association between reflux and obstructive respiratory events. Even though the data comprised a small sample size, it seems that a more complex mechanism is involved with these two highly prevalent diseases.

Auditory voice-perception analysis sensitivity and specificity in the screening of laryngeal disorders.

UNLABELLED: Despite the growing experience obtained from the National Pro-Voice Campaigns in screening individuals with laryngeal alterations, we still have not established which would be the best assessment method: speech and hearing screening alone, laryngoscopy alone, or a joint work with physicians and speech therapists doing the screening together. AIM: the goal of the present study was to assess the sensitivity, specificity, positive and negative predictive values of the auditory voice-perception analysis compared to videolaryngoscopy as a screening method for individuals with laryngo-pharyngeal disorders. MATERIALS AND METHODS: We compared the vocal aspects (GRBASI scale, pitch, loudness, CPF and resonance) and videolaryngoscopic from 567 individuals who participated in the National Pro-Voice Campaign 2005 in a tertiary university hospital. RESULTS: the most frequent laryngeal alteration was laryngo-pharyngeal reflux (LFR) (43.5%), followed by benign lesions (17%) and suspected malignant lesions (1%). The sensitivity of the auditory voice-perception assessment was of 91% for patients with benign lesions and 100% in those with suspected malignant lesions; however, it was only 76% in LFR. Of those tests considered normal, there were vocal alterations in 52%. The positive predictive value was of 71% and the negative was 61%. CONCLUSIONS: Despite its importance, the auditory voice-perception assessment should not be used as a single screening instrument in voice health campaigns.

Immunohistochemical searching for estrogen and progesterone receptors in women vocal fold epithelia.

UNLABELLED: Larynx is extremely sensitive to endocrinologic changes. Most vocal fold mucosa alterations are caused by changes in vocal fold liquid content and its epithelial changes. Estrogen and progesterone interfere and change this liquid content in the vocal folds. Our goal with the present paper is to study the presence of estrogen and progesterone receptors on vocal fold epithelium in 19 vocal fold epithelium specimens that did not present any indication of disease, especially inflammatory disease. We discarded those cases of patients above 40 years of age and those below 15. RESULTS: We found progesterone receptors in 18 of the 19 patients. The progesterone receptors are located both in the nucleus and the cytoplasm of cells, and mainly in the basal layer. There was no report of estrogen receptors present in the vocal folds. CONCLUSION: Vocal fold epithelium bears progesterone receptors, in the cytoplasm and in the nucleus. We did not find estrogen receptors in the epithelia of the vocal folds investigated.

[Incidence of structural vocal fold abnormalities associated with vocal fold polyps.

UNLABELLED: Phonotrauma is considered the main cause of vocal fold polyps (VFP). However, the authors believe that an underlying anatomical deviation could render the vocal folds more susceptible to such trauma. AIM: To prove this hypothesis a retrospective chart review was carried out to correlate the surgical findings of patients with VFP. MATERIAL AND METHODS: The charts of thirty-three patients who underwent surgery for excision of VFP were reviewed: 21 had right VFP, 10 had left VFP and 2 had bilateral lesions. RESULTS: Associated lesions were reported in 27 patients (14 lesions on the opposite VF and 13 on the ipsilateral VF): 10 opposite nodules, 12 sulcus vocalis, 3 cysts, and 2 capillary engorgement. DISCUSSION AND CONCLUSIONS: The high incidence of associated anatomical lesions to the VF (63%) suggests that patients with these minor underlying anatomical deviations are more vulnerable to vocal abuse, probably because they present abnormal glottic closure and an irregular vibratory margin.

Granular cell tumor of the larynx in children: a case report.

The granular cell tumor (GCT) is an uncommon neoplasm, with slow progression, usually benign, that can be found in any organ. The most common region for GCT involvement is in the head and neck. Laryngeal involvement is uncommon and accounts for 6 to 10% of all cases reported. Among the major theories of origin and based on the strongest evidence, the most accepted one is that the tumor stems from neuronal tissue. The GCT has a higher incidence in African-descendent patients, and most commonly in their 4th and 6th decades of life. The posterior larynx is the most common laryngeal site. Pediatric laryngeal GCT is rare, anterior subglottis involvement has been described and extensive glottic involvement may occur. Affected patients typically present with hoarseness, dysphagia, cough, haemoptysis, stridor and pain. The GCT presents as a small, firm nodule, sessile or polypoid, with intact mucosa, well outlined but not encapsulated. Cytoplasm granules are typically seen under light microscopy, and the cells are positive for S100 immunoperoxidase and neuron-specific enolase. Treatment of laryngeal GCT is based on surgical excision. This paper describes a pediatric patient with GCT and its clinical course before and after surgical treatment, stressing the importance of GCT diagnosis in the pediatric population. We review clinical course, pathology characteristics and treatment.

Acute effects of radioiodine therapy on the voice and larynx of Basedow-Graves patients.

UNLABELLED: Graves's disease is the most common cause of hyperthyroidism. There are three current therapeutic options: anti-thyroid medication, surgery, and radioactive iodine (I 131). There are few data in the literature regarding the effects of radioiodine therapy on the larynx and voice. The aim and the AIM: os this study was: to assess the effect of radioiodine therapy on the voice of Basedow-Graves patients. MATERIAL AND METHOD: A prospective study was done. Following the diagnosis of Grave's disease, patients underwent investigation of their voice, measurement of maximum phonatory time (/a/) and the s/z ratio, fundamental frequency analysis (Praat software), laringoscopy and (perceptive-auditory) analysis in three different conditions: pre-treatment, 4 days, and 20 days post-radioiodine therapy. Conditions are based on the inflammatory pattern of thyroid tissue (Jones et al. 1999). RESULTS: No statistically significant differences were found in voice characteristics in these three conditions. CONCLUSION: Radioiodine therapy does not affect voice quality.

Volar Locking Plate Fixation of Distal Radius Fractures: Splint versus Immediate Mobilization.

Background The goal of this study was to demonstrate that the use of a splint after performing an osteosynthesis of the distal radius with a volar locking plate is unnecessary. The main hypothesis was that postoperative flexion of the wrist was greater without a splint. Secondary hypothesis was that patients who were allowed immediate mobilization got better results in terms of pain, Quick Disabilities of the Arm, Shoulder and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), strength, extension, pronation, and supination. Case Description Our series included 72 patients, aged 59 years in average of which 59 were female patients. All patients had been operated for a volar locking plate fixation of a distal radius fracture. The first 36 patients (group I) were immobilized by a splint at 30° of extension of the wrist for 2 weeks. The following 36 patients (group II) were not immobilized. Results At 3 months, all the average variables were better in the group without splint (group I: flexion 74.83%, extension 83.13%, pronation 92.07%, supination 88.11%, pain 1.72/10, Quick DASH 21.78/100, PRWE 22.97/100, strength 62.96%; group II: flexion 85.50%, extension 83.4%, pronation 92.96%, supination 92.96%, pain 1.28/10, Quick DASH 19.57/100, PRWE 20.56/100, strength 66.34%). No complication was reported. Conclusion Overall, our results demonstrate that wearing a splint after volar locking plate fixation of a distal radius fracture is unnecessary.

Reliability of nasofibroscopy for the evaluation of adenoid hypertrophy and its correlation with clinical symptoms

Abstract Objective: To analyze the reliability of estimating the percentage of rhinopharyngeal obstruction by the adenoid using nasofibroscopy and its correlation with clinical symptoms. Methods: Cross-sectional observational study was conducted, involving 80 patients between 4 and 14 years old, recruited from Santa Casa of São Paulo general otorhinolaryngology outpatient service during the years of 2020 and 2021. All patients underwent nasal endoscopy examination, and the recorded videos were randomly assigned to four evaluators in two different sessions, with a minimum interval of 1 month. The evaluators estimated the percentage of rhinopharyngeal obstruction caused by the adenoid. Intra- and inter-evaluator correlations were established by comparing the reports from each evaluator. The data were compared to the Pro Image J Software report, that also estimates a percentage of obstruction by computer graphics. To correlate the grading of obstruction with clinical symptoms, all patients completed the OSA (Obstructive Sleep Apnea) 18 questionnaire, a validated tool for assessing sleep apnea in children. The questionnaire data were then compared to the average scores assigned by the evaluators. Results: Satisfactory intra- and inter-rater correlations were observed, and the results were consistent with the Pro Image J Software. However, no correlation was found between the percentage of obstruction and the severity of clinical symptoms. Conclusion: Nasofibroscopy demonstrates good reliability in assessing a percentage of rhinopharyngeal obstruction caused by adenoids. However, there is no correlation between the degree of obstruction of the rhinopharynx and the clinical symptoms. Level of evidence: 4.

Laryngeal electromyography in adults with Parkinson's disease and voice complaints.

OBJECTIVE: To study the laryngeal electromyography (LEMG) pattern in patients with Parkinson's disease (PD) and vocal complaints. STUDY DESIGN AND SETTING: Twenty-six adults with PD and vocal complaints and 26 controls with presbyphonia underwent videolaryngoscopy (VL) and LEMG. RESULTS: No tremor was found on LEMG of the cricothyroid and thyroarytenoid muscles, even in cases with clinical and VL tremor. LEMG hypertonicity during voice rest was the typical feature observed in 73% of the patients with PD versus 23% of the controls. This difference was statistically significant. The severity of the disease, diagnosis, and the time of treatment did not correlate with LEMG findings. CONCLUSION: This is the first study reporting the use of LEMG in a large series of patients with PD and vocal complaints. Patients with PD presented spontaneous intrinsic laryngeal muscle activity during voice rest. SIGNIFICANCE: The typical patterns in LEMG suggest this to be a valuable diagnostic tool in PD.

Lombard's effect's implication in intensity, fundamental frequency and stability on the voice of individuals with Parkinson's disease.

UNLABELLED: Parkinson's disease affects the central nervous system resulting in voice quality alterations. It is typically resistant to drug therapy and often persists despite extensive behavioural speech and language therapy. Previous findings show that masking noise will produce a consistent increase in voice intensity in most normal individuals (Lombard's effect). AIM: we evaluated Lombard's effect's implication in intensity, fundamental frequency and stability on the voice of individuals with Parkinson's disease (N=17). MATERIAL AND METHODS: through acoustic analysis, we evaluated intensity alterations and fundamental frequency, before and after white masking noise 40, 70 and 90 dBSL intensities, as well as variations during each vocalization and compared with a control group (N=16). RESULTS: voice intensity varied according to masking intensity, tending to non-linear increases in both groups and gender. Fundamental frequency varied, tending to non-linear increase in both groups and gender. Improvement stability occurred in fundamental frequency and vocal intensity. CONCLUSION: Lombard's effect increased intensity, fundamental frequency and improves voice stability on these patients. STUDY: clinical and experimental.

A study of the histological behavior of a rabbit vocal fold after a hyaluronic acid injection.

UNLABELLED: The vocal fold structure is composed of tissues with many cells surrounded by the extra-cellular matrix. One of the most important components of the extra-cellular matrix is Hyaluronic Acid (HA). The aim of the study was to evaluate the inflammatory response of rabbit vocal folds after a local injection of Restylane HA. METHODS: Twelve adult male rabbits randomly received a 0.1 ml injection of Restylane HA in one vocal fold and 0.1 ml of saline in the other vocal fold. The animals were prospectively subdivided into two groups; animals in one group were sacrificed after one week of follow-up and animals in the other group were sacrificed after 3 months. Slides were Hematoxylin-Eosin (HE), Masson Trichromic and Toluidine Blue stained. RESULTS: Hyaluronic Acid was found microscopically in all specimens in both groups. There was more connective tissue surrounding HA, always associated with a mild inflammatory response. The longer exposure time did not increase the intensity of inflammation. Tissue necrosis and foreign body inflammatory reaction were not observed in both groups. CONCLUSION: The study suggests that HA is a good alternative as a filling material in vocal folds when treating glottal insufficiency.

The interference of voice change on structural vocal cords lesions.

UNLABELLED: A longitudinal cohort study Introduction: Voice change may be defined as a group of changes in voice pattern that take place between childhood and puberty. During this period some vocal cord lesions (specifically cysts and nodules) may undergo transformation. AIM: To evaluate changes in vocal cord structural lesions following voice changes. MATERIAL AND METHOD: All laringoscopic exams made at the Sao Paulo Santa Casa de Misericordia between 1997 and 2002 of children aged below 10 years with structural lesions were reevaluated. Children whose voice had already changed repeated the exam and answered a questionary about voice change. RESULTS: Eleven children were studied. Observation showed that hoarseness was significantly decreased after voice change, and that lesions revealed modifications. Thickened-like lesions were reabsorved, and protrusion-like lesions underwent modification but did not disappear. CONCLUSION: The definition of lesions and subsequent modifications after voice change are important to define the correct approach to children presenting hoarseness.

Extra-laryngeal complications of suspension laryngoscopy.

UNLABELLED: Although suspension laryngoscopy is routinely used in laryngeal surgery, there are only few studies on the complications of this procedure. AIM: to evaluate the complications outside the larynx following suspension laryngoscopy and analyze their relation with surgery duration. MATERIALS AND METHODS: Thirty-seven procedures were prospectively analyzed for intervention-related complications. The study included patient preoperative and postoperative assessment, focusing on dental, mucosal and nerve status (hypoglossal and lingual nerves). RESULTS: Most procedures (27/37) were associated to some kind of complication, and mucosal injuries were the most common; temporary nerve lesions were observed in five cases and dental injuries in one case. Statistic significance was found between surgery duration and mucosal injury (lesions smaller than 1 centimeter), showing that longer procedure pose higher risks for these complications. CONCLUSION: These findings suggest that suspension laryngoscopy is frequently associated with complications outside the larynx. Although these injuries represent a low risk of significant morbidity, they can be avoided if more accurate techniques are used.

Effect of Levodopa + Carbidopa on the Laryngeal Electromyographic Pattern in Parkinson Disease.

BACKGROUND: Vocal impairment is one of the main debilitating symptoms of Parkinson disease (PD). The effect of levodopa on vocal function remains unclear. OBJECTIVE: This study aimed to determine the effect of levodopa on electromyographic patterns of the laryngeal muscle in patients with PD. STUDY DESIGN: This is a prospective interventional trial. METHODS: Nineteen patients with PD-diagnosed by laryngeal electromyography-were enrolled. Cricothyroid and thyroarytenoid (TA) muscle activities were measured at rest and during muscle contraction (phonation), when participants were on and off medication (12 hours after the last levodopa dose). RESULTS: Prevalence of resting hypertonia in the cricothyroid muscle was similar in the off and on states (7 of 19, P = 1.00). Eight patients off medication and four patients on medication had hypertonic TA muscle at rest (P = 0.289). No electromyographic alterations were observed during phonation for either medication states. CONCLUSION: Despite a tendency for increased rest tracings in the TA muscle when participants were on medication, no association was found between laryngeal electromyography findings and levodopa + carbidopa administration.

Effect of application of fibrin glue on vocal fold healing after surgical manipulation in rabbits / Efeito da aplicação de cola de fibrina na cicatrização de pregas vocais após manipulação cirúrgica em coelhos

Abstract Introduction A challenge in phonosurgery is achieving good vocal quality with minimal vocal fold fibrosis. Fibrin glue can be applied to minimize fibrosis; however, its use in the larynx is based primarily on clinical experience, particularly in extensive lesions. Objective The objective of this study was to evaluate the effect of application of fibrin glue on collagen concentration at the late phase of the healing process after detaching a pedicled flap of the vocal fold cover in rabbits. Methods In this prospective animal study, twelve adult male rabbits underwent laryngeal microsurgery, in which an incision was made along the entire length of both vocal folds, followed by extensive mucosal detachment and section of the incision ends. Fibrin glue was applied in the left vocal fold, and the mucosa was repositioned. In the right vocal fold, the mucosa was repositioned without treatment with fibrin glue. After 3-months, the rabbits were euthanized. Histological analyses were performed, and the data collected were subjected to statistical analysis. Results Vocal folds treated with fibrin glue presented higher collagen concentration in Masson trichrome staining and significantly higher (p< 0.05) collagen concentration in picrosirius red staining compared to control vocal folds. Conclusion Treatment with fibrin glue led to greater vocal fold fibrogenesis in the present study. Nonetheless, further studies are necessary to determine the prophylactic effect of sealants in laryngeal surgeries that require extensive detachment of the vocal fold cover.

Resumo Introdução Um desafio na fonocirurgia é conseguir uma boa qualidade vocal com o mínimo de fibrose das pregas vocais. A cola de fibrina pode ser aplicada para minimizar a fibrose; porém, seu uso na laringe é baseado principalmente na experiência clínica, particularmente em lesões extensas. Objetivo Avaliar o efeito da aplicação da cola de fibrina na concentração de colágeno na fase tardia do processo de cicatrização, após o descolamento do retalho pediculado da cobertura da prega vocal em coelhos. Método Neste estudo prospectivo com animais, 12 coelhos adultos machos foram submetidos à microcirurgia de laringe, na qual uma incisão foi feita em toda a extensão de ambas as pregas vocais, seguida de extenso descolamento da mucosa e secção das extremidades da incisão. A cola de fibrina foi aplicada na prega vocal esquerda e a mucosa foi reposicionada. Na prega vocal direita, a mucosa foi reposicionada sem tratamento com cola de fibrina. Após três meses, os coelhos foram sacrificados. Análises histológicas foram feitas e os dados coletados foram submetidos à análise estatística. Resultados As pregas vocais tratadas com cola de fibrina apresentaram maior concentração de colágeno na coloração tricrômica de Masson e concentração significativamente maior de colágeno (p < 0,05) na coloração com picrosirius red comparadas às pregas vocais controle. Conclusão O tratamento com cola de fibrina resultou em maior fibrogênese das pregas vocais no presente estudo. Contudo, novos estudos são necessários para determinar o efeito profilático dos selantes em cirurgias de laringe que requerem extenso descolamento da cobertura das pregas vocais.