Mucous and epidermoid cysts in professional singers: a different therapeutic challenge???
Intracordal cysts, mucous and epidermoid, are not uncommon lesions in professional voice users and eventually will necessit microsurgical treatment.
From our 40 years experience, the 2 types of intracordal cysts differ in videostroboscopic appearance although vocal impact in both groups is similar. But surgical difficulties, surgical outcomes and short- and long term seemed very different in both groups, with better results after microsurgery in mucous cysts. In literature, comparative data on functional evolution of intracordal cysts of both types is extremely limited.
In order to demonstrate our hypothesis, we performed a retrospective study including 69 patients who underwent a mini-microflap excision (C. Finck) of vocal cyst between 2014 and 2024 Data collected include demographic characteristics, histological type, recurrence, contralateral involvement, follow-up duration, and voice evaluations performed preoperatively, postoperatively, and at last follow-up. Voice assessment comprise perceptual (GRBAS), aerodynamic (TMP), patient-reported (VHI), and acoustic parameters (jitter, DSI). Statistical analyses used nonparametric tests with significance set at p ≤ 0.05.
The cohort is mainly female (88%), with a median age of 39.5 years. Thirty-five patients had epidermoid cysts and 34 had mucous cysts. Recurrence (11.1%) and contralateral vocal fold lesions (18.5%) occurred only in epidermoid cysts, which also had longer follow-up. Preoperative findings were similar between groups. Postoperatively, perceptual grade, VHI, and DSI favored mucous cysts. At last follow-up, GRBAS scores and VHI remained significantly worse in epidermoid cysts.
Epidermoid cysts are associated with higher recurrence, contralateral involvement, and poorer long-term voice outcomes, supporting histology-based management and extended follow-up.
In this presentation, are going to be discussed the laryngeal videostroboscopic appearance, the surgical difficulties and the vocal outcomes in both groups, with a specific attention to microsurgical treatment of these intracordal lesions in professional singers.