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What is vocal cord surgery?

Vocal cord surgery, also known as laryngeal surgery or laryngoscopy, is a very successful and effective treatment for a variety of laryngeal conditions such as vocal cord nodules, polyps, and cysts. The surgery can be performed traditionally, microscopically or through a laser. Generally, minimally invasive or laser surgeries are preferred as they reduce the risk of vocal cord scarring and do not have a severe impact on the patient’s voice quality.

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When is vocal cord surgery required?

When is vocal cord surgery required?

Vocal cord surgery is performed for the removal of laryngeal lesions, like benign nodules, cysts, polyps, etc., without affecting the patient’s vocal ability. It is often required in:

  • people who overuse their voice, i.e., scream or talk loudly regularly for long periods of time.
  • people with ulcers (sores or erosion) on vocal folds due to gastroesophageal reflux disease (GERD) or heartburn
  • people with damaged vocal cords due to smoking, drinking, infections, etc.
  • people with benign or malignant vocal cord lesions, or infected or inflamed vocal cords
  • people suffering from laryngeal palsy
  • transgender people for Adam’s apple reduction during sex change procedure

How to prepare for vocal cord surgery?

How to prepare for vocal cord surgery?

The surgery can be a little complex and can potentially lead to severe ramifications for the patient’s everyday life. Therefore, before the surgery, every patient should be given thorough education regarding the risks and benefits of the surgery. If the patient is a smoker, then they should quit the habit to ease the hoarseness and irritation of the vocal folds. They should rest their voice and avoid eating foods that can cause acidity.

What happens during vocal cord surgery?

What happens during vocal cord surgery?

Before the surgery, a thorough diagnosis is necessary to ensure the efficacy of the treatment plan in managing the patient’s symptoms. Diagnosis before vocal cord surgery is generally based on direct or indirect visualization via a mirror or laryngoscope. In case cancer is suspected, biopsy of the lesion is also recommended before surgery planning. Other diagnostic tests that may be performed include blood tests, MRI scan, laryngeal electromyography, etc.

The vocal cord surgery procedure may differ based on the type of surgery.

Different types of vocal cord surgeries are:

  • Laser vocal cord surgery: The surgery involves use of a laser to remove vocal cord lesions, tumors, polyps, etc. It usually takes about 60-90 minutes and provides the best outcome for the surgery.
  • Laryngeal framework surgery: During this surgery, the surgeon modifies the cartilages attached to the vocal cords to provide better cord vibration and tension to improve the quality of voice. The surgery is performed under local anesthesia, so that the patient can provide regular feedback regarding their voice as their voice is being adjusted.
  • Vocal cord injections: This procedure involves the injection of collagen and other gel fillers to treat temporary vocal cord conditions like paralysis, muscle weakness, etc.
  • Laser endoscopic cricopharyngeal myotomy: This surgery is performed in case of severe dysphagia and involves muscular reconstruction of the vocal folds.

What are the benefits of vocal cord surgery?

What are the benefits of vocal cord surgery?

Vocal cord surgery is the most effective and minimally invasive treatment for the diagnosis and treatment of a variety of vocal fold lesions such as cancer, cysts, papilloma, polyps, and Reinke’s edema. It also provides effective management for acute or chronic trauma to the vocal cords. 

Most patients also need surgery intervention if they have dysphonia (poor voice quality), dysphagia (difficulty in swallowing), or stridor (abnormal, high-pitched, musical breathing sound) due to airway obstruction.

Long-term benefits of vocal cord surgery are:

  • Restoration of vocal strength and quality
  • Long-term treatment of vocal cord lesions
  • Treatment for damaged voice nerves and tissues
  • Change of vocal tone and pitch for transgender people

What to expect after a laryngoscopy?

What to expect after a laryngoscopy?

The patient may have slight pain and discomfort, but that is usually managed through over-the-counter medications. They can resume work within a couple of days, especially if your job doesn’t require speaking too much.

Complete recovery usually takes at least 1-3 months, depending on the type and complexity of the surgery. Most patients don’t have significant improvement in their vocal quality for the first couple of weeks so they should stay patient and follow recovery tips as suggested by their doctor.

What are the complications associated with vocal cord surgery?

What are the complications associated with vocal cord surgery?

The surgery is performed very carefully and with minimal cuts to ensure no damage occurs to the oral or vocal tissues, however in some cases, it can result in complications like:

  • Temporary numbness or tingling sensation in the tongue
  • Damage to the teeth
  • Vocal fold scar
  • Breathing problems
  • Permanent change in the voice
  • Allergic reaction to the anesthesia
  • Infection 

Out of these, the most problematic complication is vocal fold scar as it can affect the voice quality and necessitate further treatment for the patient. You should consult the doctor if you notice any signs of complications such as difficulty breathing, sore throat, difficulty in swallowing (worse than before the surgery), fever, etc.

Which recovery tips should a patient follow after vocal cord surgery?

Which recovery tips should a patient follow after vocal cord surgery?

Following the surgery, the patient should follow the given recovery and precautionary tips to improve recovery and prevent complications:

  • Eat only soft foods during the first 24 hours after the surgery. You should also avoid fried, spicy, or hard foods that may scratch your throat or disturb the incision. If it is too difficult to swallow soft foods, you can stick to a liquid diet.
  • Hydration is very important after the surgery, especially since it is performed under general anesthesia. Drink at least 8 large glasses of water everyday. You should also inhale steam 4-5 times a day for 5-10 minute intervals to soothe your throat.
  • You should rest your voice for at least 2 weeks following the surgery. Don’t talk on your phone or whisper at all during this time to avoid straining your vocal cords. If you do have to speak, drink sips of water in between to keep vocal tissues moist.
  • Don’t smoke for at least 3 weeks after the surgery and other areas where you may be exposed to smoke as exposure to smoke can irritate the vocal cords and delay recovery.
  • Avoid alcohol, coffee, and other caffeinated beverages for the first 3 weeks as they can irritate the throat, delay healing and lead to thick mucus formation around the surgery site.
  • Make sure you come to your doctor for regular follow up check ups till you have recovered. 
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