الفهرس 
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Abstract
Minimal associated pathological lesions of the larynx (MAPLs) are a group of related lesions that affect voice production leading to voice handicape and can be diagnosed by laryngoscopy and stroboscopy. This group contains vocal fold nodule, polyp, cyst, Reinek’s oedema and contact granuloma. There are several lines for teating these lesions such as pharmacotherapy, voice therapy and microlaryngosurgery (MLS). One of the most important complications after MLS is postoperative Dysphonia that may be due to vocal fold scaring. Several agents had been used to prevent vocal fold scaring such as corticosteroids, penicillamine, and Mitomycin C (MMC) that can prevent scaring by inhibition of fibroblast proliferation.
This study designed to assess the effect of MMC on vocal fold healing after MLS.the current study included 27 patients with MAPLs diagnosed by endoscopic examination and stroboscopy. They were randomly divided into 2 groups; group A contained 13 patients (age ranging from 18-64 years, with mean age 37.62 ± 13.836) and group B contained 14 patients ( age ranging from 21-56 years, with mean age 34.07 ± 10.381). each patient was subjected to full history taking, endoscopic and stroboscopic examination and voice assessment subjectively and objectively. 1cc of 0.5 mg/ml MMC was applied to patients of group A locally for 5 minutes after MLS where saline was applied to patients of group B as a control. The patients were followed up after 2, 4 and 8 weeks and each time they were subjected to endoscopic and stroboscopic examination and voice assessment subjectively and objectively. The data collected from each follow up were statistically analyzed.
There was no statistically significant difference between both groups as regard sex, age and predisposing factors as smoking and voice misuse meaning that these were comparable groups. The results of our study showed more improvement in group A than group B after 2 weeks with earlier regain of the mucosal wave but this improvement was not statistically significant except for fhi. After 4 weeks the improvement in both groups nearly equal and there was no significant difference between them except in Fhi that show significant improvement in group A. By the end of the 8th week there was no statistically significant difference between both groups and there was normal mucosal wave in all cases with complete glottis closure.
This improvement in patient voice was assessed subjectively on patient base by using VPSS (Subjective evaluation of voice by voice problem self-rating scale) and on clinician base by using GRBAS. Also the patient’s improvement was assessed objectively acoustic analysis, maximum phonation time and Dysphonia severity index.