Should antiviral medications be considered preoperatively for microlaryngoscopy in patients with a history of recurrent herpes stomatitis?

Abstract

Infectious complications following phonomicrosurgery are rare. Reports of herpetic laryngitis are in the literature but none following microlaryngoscopy. We present a case of a 55-year-old female who underwent microsurgical excision of a left vocal fold (VF) lesion and KTP ablation of bilateral vascular ectasias. Postoperative stroboscopy demonstrated severe bilateral VF edema, erythema, and ulcerations of the VFs, encompassing an area greater than the original surgical field. Initial management included voice rest, antibiotics, steroids, and aggressive reflux treatment. The patient experienced prolonged VF edema and poor voice outcome, which ultimately resolved over 6 months. Clinical diagnosis of herpetic laryngitis was presumptively made after the patient revealed a history of relapsing oral herpes incited by stress with a recent episode before microlaryngoscopy. This case highlights the importance of thorough review of a patient's medical history. A protocol for preoperative (prophylactic) antiviral therapy and appropriate timing of surgery is presented for patients with history of herpes infection.

• Authors: VyVy N Young, Priya Krishna, Clark A Rosen
• Journal: Journal of voice : official journal of the Voice Foundation (J Voice) Vol. 27 Issue 1 Pg. 115-8 (Jan 2013) ISSN: 1873-4588 [Electronic] United States
• PMID: 22795982 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Chemical References

• Antiviral Agents

Topics

• Antiviral Agents (therapeutic use)
• Female
• Herpes Simplex (complications)
• Humans
• Laryngitis (prevention & control, virology)
• Laryngoscopy (adverse effects)
• Middle Aged