Vocal chord surgery – Microlaryngoscopy

Vocal chord surgery concerns operations for the management of benign vocal cord conditions, such as polyps, nodules, cysts, polypoid degeneration (Reinke’s oedema), papillomas and laryngeal hernias. These lesions manifest mainly as hoarseness. Thanks to the use of a microscope and a special laryngoscope, microlaryngoscopy allows these operations to be performed endoscopically, accurately (thanks to zooming) and without incisions, which is very important for postoperative voice quality.

How are voice problems diagnosed?

Contemporary flexible or rigid endoscopes can be connected to a monitor, offering a clear picture of the vocal chord lesion. Indeed, an even more specialised examination, called stroboscopy, now exists. It is used by specialists to visualise vocal fold vibration and can reveal abnormalities that are not possible to identify by simple laryngoscopy. A comprehensive diagnosis is very important, as it determines the correct therapeutic strategy.

What is the appropriate treatment for these problems?

Usually, treatment is initially conservative and includes care and medication for pre-disposing conditions such as allergies or gastroesophageal reflux, as well as a correct diet, avoidance of smoking, alcohol and irritants in general. However, when this treatment is not effective, or when a malignancy is suspected, surgery may be required. The determining factor for taking the right decision is the doctor’s extensive experience and expertise.

What are the latest surgical techniques?

The contemporary surgical management of these lesions in some cases uses a microflap technique, and various types of laser (CO2- KTP) that are much less traumatic for the sensitive vocal cord mucosa and provide better voice quality postoperatively.

Postoperative course

In operations for benign lesions, postoperative aphonia for about 5 days is crucial for proper healing. Speech therapy may also often be necessary, both preoperatively and postoperatively. Finally, the follow-up of the patient by laryngoscopy and stroboscopy after surgery reduces the risk of recurrence, in cases of both benign or malignant lesions.

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