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VOLUME 2 , ISSUE 2 ( July-December, 2012 ) > List of Articles


Subepithelial Vocal Fold Cyst: A Pearl on a String?

Nupur Kapoor Nerurkar, Sunita Chhapola Shukla

Citation Information : Nerurkar N K, Shukla SC. Subepithelial Vocal Fold Cyst: A Pearl on a String?. Int J Phonosurg Laryngol 2012; 2 (2):53-56.

DOI: 10.5005/jp-journals-10023-1037

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2012; The Author(s).



Subepithelial vocal fold cyst (SEVFC) is an epithelium lined sac within the lamina propria. These cysts are of two histologic types: Mucous retention cyst and epidermoid cyst. Rupture of the cyst during surgical excision and incomplete cyst wall removal with consequent recurrence of the cyst is not an infrequent problem. While performing cold-steel blunt microflap surgery for SEVFC, the first author observed thick fibrotic bands at the 12 and 6 o'clock position in all the cases, giving the appearance of a ‘pearl (cyst) on a string (fibrotic bands)’. In most cases of cyst rupture, it took place during dissection of these bands. The aim of our study was to see if there was any significant difference in rupture and recurrence rate by sharp versus blunt dissection of these fibrotic bands.

Study design

Retrospective nonrandomized cohort comparison.

Materials and methods

Fifty-nine subepithelial cysts were operated by microflap technique. The first 26 cysts were taken in alternation for blunt vs sharp dissection of the fibrotic bands. As the results of sharp dissection were better, the subsequent 33 cysts were operated with sharp dissection of the anterior and posterior bands.


Sharp dissection of the anterior and posterior bands during microflap dissection reduced the incidence of cyst rupture (p = 0.006) and recurrence (p = 0.007) of cyst formation.


SEVFC are anchored by thick fibrotic bands at the 12 and 6 o'clock position giving it the appearance of a ‘pearl (cyst) on a string (fibrotic bands)’. Sharp dissection of these bands during microflap dissection reduces the incidence of cyst rupture and recurrence.

How to cite this article

Nerurkar NK, Shukla SC. Subepithelial Vocal Fold Cyst: A Pearl on a String? Int J Phonosurg and Laryngol 2012;2(2):53-56.

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