Our Summary

This study focused on the impact of a medical procedure called endarterectomy on voice quality and vocal cord function. The procedure, which is used to remove fatty deposits from the arteries, can sometimes lead to a rare but serious complication: paralysis of the recurrent laryngeal nerve, which controls the vocal cords.

The researchers analyzed 200 patients who underwent this procedure. They examined their vocal cords and voice quality before the operation, immediately after, two days later, and then three and six months later.

The results showed that patients who underwent this procedure had a shorter maximum phonation time (how long they could sustain a sound) and worse results on the GRBAS scale, which measures voice quality. When asked to rate their own voice, many patients said they found it difficult to speak loudly or be heard and they often felt short of breath when speaking. Also, a higher number of these patients reported voice disorders after the procedure.

However, the researchers also found that most of these issues were temporary and resolved over time. Only 3% of patients were left with permanent vocal cord paralysis.

The study concludes that while these side effects are common, they are usually temporary. However, they can significantly impact a patient’s quality of life, so voice rehabilitation and psychological support should be provided. The study also recommends that vocal cord evaluation should be done before and after any neck surgery to monitor these potential effects.

FAQs

  1. What is endarterectomy and how can it affect vocal cords?
  2. What were the findings of the study regarding voice quality after undergoing endarterectomy?
  3. What recommendations does the study make for patients undergoing neck surgery in relation to potential vocal cord issues?

Doctor’s Tip

A doctor may advise a patient undergoing vocal cord surgery to:

  1. Follow all post-operative care instructions provided by the surgeon to ensure proper healing.

  2. Rest the voice and avoid speaking or singing excessively for a period of time after surgery to allow the vocal cords to heal.

  3. Attend speech therapy or vocal rehabilitation sessions to help improve voice quality and function after surgery.

  4. Stay hydrated and avoid irritants such as smoking or excessive caffeine intake, which can affect vocal cord health.

  5. Monitor any changes in voice quality or difficulty speaking and report them to the doctor promptly.

  6. Be patient with the recovery process, as it may take time for the vocal cords to fully heal and for voice quality to return to normal.

Suitable For

Patients who are typically recommended vocal cord surgery include those with:

  1. Vocal cord paralysis or weakness
  2. Vocal cord nodules, polyps, or cysts
  3. Vocal cord injuries or trauma
  4. Vocal cord cancer
  5. Spasmodic dysphonia
  6. Laryngeal papillomatosis
  7. Vocal cord dysfunction
  8. Vocal cord muscle tension
  9. Voice disorders that do not improve with voice therapy or other conservative treatments

It is important for patients to undergo a thorough evaluation by an otolaryngologist (ear, nose, and throat specialist) to determine if vocal cord surgery is the appropriate treatment option for their specific condition.

Timeline

Overall timeline of patient experience before and after vocal cord surgery:

  • Before surgery: Patients may experience symptoms such as hoarseness, difficulty speaking loudly, shortness of breath when speaking, and voice disorders. Vocal cord evaluation is done to assess the condition of the vocal cords.

  • Day of surgery: Patients undergo vocal cord surgery to address issues such as vocal cord paralysis or other vocal cord disorders.

  • Immediately after surgery: Patients may experience temporary changes in voice quality, such as a shorter maximum phonation time and difficulty speaking loudly.

  • Two days post-surgery: Patients continue to experience temporary voice changes and may find it challenging to be heard.

  • Three months post-surgery: Many of the temporary voice changes have resolved, but some patients may still have lingering issues with voice quality.

  • Six months post-surgery: Most patients have fully recovered from the surgery, with only a small percentage experiencing permanent vocal cord paralysis.

Overall, vocal cord surgery can lead to temporary changes in voice quality, but with proper care and rehabilitation, most patients can recover and regain their normal voice function. Monitoring and support from healthcare professionals are essential to ensure a successful outcome for patients undergoing vocal cord surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vocal cord surgery include:

  1. What are the potential risks and complications associated with this surgery, specifically related to vocal cord function?
  2. How will my voice quality be evaluated before and after the surgery?
  3. What can I expect in terms of changes to my voice immediately after the surgery and in the months following?
  4. Will I need voice rehabilitation or therapy after the surgery, and if so, what does that entail?
  5. What is the likelihood of experiencing permanent vocal cord paralysis as a result of this surgery?
  6. How will my ability to speak, sing, or project my voice be affected by this procedure?
  7. Are there any alternative treatments or procedures that could achieve similar results with less risk to my vocal cords?
  8. How experienced is the surgical team in performing procedures that involve the vocal cords?
  9. How soon after the surgery can I expect to regain normal vocal cord function, and what can I do to support my recovery?
  10. Are there any specific lifestyle changes or precautions I should take to protect my vocal cords post-surgery?

Reference

Authors: Dorobisz K, Dorobisz T, Pazdro-Zastawny K, Kubacka M, Janczak S, Janczak D. Journal: Vasc Health Risk Manag. 2024 Aug 21;20:369-375. doi: 10.2147/VHRM.S465573. eCollection 2024. PMID: 39184144