Introduction: A vast majority of polyps appear at the predilection site of the vocal fold and therefore belong to the functional-traumatic group of vocal fold lesions. According to their size, vocal fold polyps may severely interfere with the glottal closure, and induce hoarseness, vocal fatigue, and frequently hyperkynetic pattern of voice production.
Material and method: A series of 699 polyps was operated by direct microlaryngoscopy (DML), indirect microstroboscopy (IMS), and indirect videostroboscopu (IVS). Postoperative functional results were estimated by stroboscopy. Based on the functional results, specific indications were established for the use of each operative technique.
Results: Functional results in our series were satisfactory. We used DML in 152 patients, IMS in 432 cases, and IVS in 115 phonosurgical procedures. Indirect surgery was used in 547 patients (78.2%). It was established that indirect procedures were very suitable for small vocal fold lesions with narrow base, and good demarcation towards the normal vocal fold tissue. Direct procedures should be used for massive growths with wide base, and poor demarcation towards the normal vocal fold tissue. The patient's preference for a particular technique and possible contraindications for either direct of indirect procedure, should also be considered.
Discussion: Direct and indirect procedures are complementary, and each has its own indications. IVS technique is technically simpler in comparison with IMS procedure. Each phonosurgeon must be able and skilled to use both direct and indirect phonosurgical techniques.