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What is Laryngeal surgery?


Laryngeal surgery is a general name for many different types of procedures that can be performed on the larynx (the vocal cords and related structures) .


What are the indications for laryngeal surgery?


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 child will usually exhibit a hoarse or raspy voice. 

Laryngeal 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. 

Please see HOARSENESS and VOCAL CORD DISORDERS for more information.


How is laryngeal surgery performed?


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). An open surgical approach is most often performed after trauma or fracture of the larynx (upper front of neck) has occurred. Please see REPAIR OF FACIAL AND NECK TRAUMATIC INJURIES.


Although the open surgical approach allows somewhat better control of the vocal cords during the procedure, the endoscopic approach may be more successful in restoring more normal voice sound. The endoscopic approach also has the advantage of allowing extremely close observation of the vocal cords, therefore resulting in a precise and accurate cut or removal of tissue. However, not all procedures can be performed endoscopically. 

Recovery after either an open or endoscopic approach includes minimizing damage to the larynx during surgery, as well as reducing inflammation after the surgery. Therefore, your surgeon will recommend the procedure he/she feels will minimize these complications. 


What is involved with endoscopic laryngeal surgery?

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 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.

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