Phonosurgery of the vocal folds: a classification proposal.

The Phonosurgery Committee of the European Laryngological Society (ELS) has examined the definition and technical description of phonosurgical procedures. Based on this review, the committee has proposed a working classification. The current presentation is restricted to vocal fold surgery (VFS) with phonosurgical intent. Both the pathology and the therapeutic aim define VFS: (1). vocal fold lesions that impair vibratory movements require excision (e.g., vocal fold nodule), incision and suction (e.g., Reinke's edema), dissection and/or augmentation (e.g., sulcus-vergeture), coagulation or vaporization (e.g., varicosity) and incision and stenting (e.g., glottal web); (2.vocal fold movement disorders require position and/or tension correction by augmentation (e.g., vocal fold paresis), injection (e.g., botulinum toxin for spasmodic dysphonia) and excision (e.g., dysphonia plicae ventricularis). This presentation excludes surgical instrumentation, implants or injectable materials. Being essentially surgeon-dependent, usage may vary over time and with experience.