To the Editor.—We read with interest the article by Mahieu and Dikkers1 on indirect microlaryngostroboscopic surgery. This intriguing new procedure raises several issues that need to be addressed. First, on a historical note, indirect binocular microlaryngoscopy has been a standard procedure in European medical centers for many years. However, it is rarely performed within the United States, although one of us is familiar with its use (H.V.L.). Since this technique is not taught in most otolaryngology training programs in the United States, its general adaptation seems unlikely in this country. Moreover, to perform surgical procedures via indirect microlaryngoscopy requires significant expertise and not "... slightly more experience." Most American laryngologists and their patients prefer general anesthesia for precision surgery on the vocal folds.
To achieve uniformly good results in the surgical treatment of benign lesions of the vocal folds, careful attention is required to both anatomy and physiology.2
ALESSI DM, VON LEDEN H. Stroboscopy and Phonosurgery. Arch Otolaryngol Head Neck Surg. 1992;118(9):1003-1004. doi:10.1001/archotol.1992.01880090119034