Allergy Testing Services performed by Lake Mary based Ear Nose and Throat Specialist, Dr. Cecelia Damask. Dr. Damask serves Central Florida, Orange County, Volusia County, Seminole County, Orlando, Lake Mary, Altamonte Springs, Sanford, Maitland, Winter Springs, Longwood, Casselberry, Heathrow and Apopka.
Vocal cord surgery is a general name for many different types of procedures that can be performed on the vocal cords.
Vocal Cord surgery is performed when the vocal cords have growths, such as, polyps, tumors, or other masses that need to be removed for biopsy or to improve function. The patient will usually exhibit a hoarse or raspy voice.
Vocal Cord surgery is also indicated to normalize vocal cord functioning when the vocal cords are scarred from various causes, paralyzed, or are otherwise abnormal. These conditions may interfere with the complete opening and/or closing of the vocal cords, which is necessary for normal speech and breathing.
Surgery on the vocal cords can be performed either directly in an open surgical approach (making an incision in the neck) or indirectly through an endoscopic approach (through a tube inserted into the mouth and throat).
Either procedure is performed under general anesthesia (the patient is fully asleep).
Endoscopic vocal cord surgery is basically microlaryngoscopy (magnified examination of the vocal cords) in addition to a corrective procedure performed on the vocal cords.
As mentioned above, this surgery is performed with the patient under general anesthesia (fully asleep). The patient is lying on the back and a laryngoscope is inserted in the mouth to hold down the tongue and visualize the vocal cords. A special telescope or operating microscope is used to get very close and detailed views of the vocal cords and surrounding areas.
There are many different methods used to correct vocal cord abnormalities. These can include using forceps (like tweezers) to hold a bump or nodule and small scissors or the CO2 laser (see below) may be used to remove it. Powered instruments may also be used to remove lesions. These rotating blades remove growths such as papillomas with very little damage to normal tissue.
Defects on the vocal cords or surrounding areas may be repaired by injections, flaps of tissue, or grafts depending on the size of the defect.
The surgery itself usually lasts about an hour, but is highly variable. Removal of nodules or bumps or more simple reconstructive procedures may not require an overnight stay in the hospital. More complex procedures may require a hospital stay.
Laser stands for "light amplification by stimulated emission of radiation". The CO2 laser device increases the intensity of light waves using CO2 (carbon dioxide) and concentrates them in an intense, penetrating beam of light. This is similar in a way to using a magnifying glass to concentrate the sun's rays; the "concentrated" sun rays underneath the magnifying glass get hot enough to burn paper for example. Similarly, the CO2 laser beam can be used to very accurately "burn off" areas of tissue that need to be removed, (vaporized).
The CO2 laser can be passed through the glass of the operating microscope, allowing for very accurate placement of the laser beam on the vocal cords. This method of tissue removal is much more precise than surgical scissors, and results in less bleeding and inflammation to the surrounding tissues. As mentioned previously, the less traumatic the surgical procedure, the more favorable the outcome, including faster recovery.
Although the laser can precisely vaporize the desired tissue, it can also accidentally burn basically anything else it may come in contact with. Therefore, safety precautions have been made to avoid this complication. These safety precautions include protective eye gear for both the patient and the operating team. A wet cloth may also be placed over the patient's face and eyes. Also, as the breathing tube can catch on fire, these surgeries are usually performed without a breathing tube in place while the laser is in use. In addition, the lowest amount of oxygen needed is used during the procedure.
The risks with the use of the CO2 laser are described above. The short-term risks of vocal cord surgery in general include chipped teeth (protective teeth guards are used during surgery to help prevent this), bleeding, breathing difficulties, hoarseness, change in voice quality, or infection.
Long term risks include a less than desired outcome in regaining normal voice or scarring from the surgery that may need additional surgical repair in the future.
Your surgeon will discuss these with you in detail.
Recovery after vocal cord surgery is dependent on the surgical procedure, as well as how well inflammation and swelling are controlled after the surgery. Your surgeon will give you guidelines on how to start reusing your voice. It is important to follow to these guidelines and keep all recommended follow up appointments to regain optimal vocal cord function.