Our Summary

This research paper discusses a new technique for conducting microlaryngoscopy - a procedure to examine the larynx (voice box) using a small flexible telescope. Traditionally, doctors have used certain methods like jet ventilation, special tubes, or even temporary cessation of breathing (apnea) to make this procedure possible. However, these processes have some limitations, such as limited operation time in the case of apnea.

Recently, the use of high-flow nasal cannula (a device used to deliver oxygen) has gained popularity in intensive care units and operating rooms. This has opened up new possibilities for conducting microlaryngoscopy without the need for tubes. In this report, the authors describe a specific case where they used a high-flow nasal cannula on a patient who could breathe on their own. This provided an ideal condition for the procedure and also for studying the patient’s vocal cords using electromyography (a technique for recording and analyzing the electrical activity produced by skeletal muscles). The paper suggests there is still a lot to learn about using high-flow nasal cannula for microlaryngoscopy.

FAQs

  1. What ventilation methods were previously used during microlaryngoscopy?
  2. How does the use of high-flow nasal cannula in microlaryngoscopy create an optimal tubeless surgical field?
  3. What are the benefits of using high-flow nasal cannula for vocal cord surgery and electromyography?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vocal cord surgery is to follow post-operative care instructions carefully, including voice rest and avoiding irritants like smoking or yelling, to ensure proper healing and optimal outcomes. It is also important to attend follow-up appointments and vocal therapy sessions as recommended by your healthcare provider.

Suitable For

Patients who may be recommended vocal cord surgery include those with vocal cord nodules, polyps, cysts, or other benign lesions that affect vocal cord function. Patients with vocal cord paralysis or other structural abnormalities that impact voice production may also be candidates for vocal cord surgery. Additionally, patients with chronic hoarseness, difficulty breathing, or other voice-related issues that do not improve with non-surgical treatments may be recommended for vocal cord surgery.

Timeline

Before vocal cord surgery:

  • Patient presents with voice changes, hoarseness, or other vocal cord issues
  • Consultation with an otolaryngologist or laryngologist to determine the need for surgery
  • Pre-operative evaluation and testing to assess vocal cord function and overall health
  • Discussion of surgical options, risks, and benefits with the patient
  • Consent for surgery obtained
  • Pre-operative instructions given to the patient, including fasting guidelines and medication adjustments

After vocal cord surgery:

  • Patient undergoes microlaryngoscopy with or without vocal cord electromyography
  • High-flow nasal cannula is utilized to provide optimal oxygenation and create a tubeless surgical field
  • Surgery is performed to address the vocal cord issue, such as vocal cord nodules, polyps, or paralysis
  • Post-operative care includes monitoring for complications, pain management, and voice rest
  • Follow-up appointments scheduled to assess surgical outcomes and monitor vocal cord healing
  • Voice therapy may be recommended to improve vocal cord function and prevent future issues

What to Ask Your Doctor

  1. What specific type of vocal cord surgery will I be undergoing?

  2. What are the potential risks and complications associated with this surgery?

  3. How long is the recovery period expected to be after the surgery?

  4. What type of anesthesia will be used during the surgery?

  5. Will I need to follow any specific post-operative care instructions?

  6. How successful is this type of surgery in improving vocal cord function?

  7. Are there any alternative treatment options to consider?

  8. How many similar surgeries have you performed in the past, and what is your success rate?

  9. Will I need to undergo any additional tests or procedures before the surgery?

  10. What should I expect in terms of pain management after the surgery?

Reference

Authors: Zee H, Song SA, Sahani N, Macias AA, Song PC, Juang J. Journal: A A Pract. 2020 Feb 15;14(4):99-101. doi: 10.1213/XAA.0000000000001154. PMID: 31842194