Our Summary

This research paper discusses a type of surgery that modifies the structure of the larynx, or voice box, to improve voice quality. This is mainly done by changing the position and tension of the vocal cords. The most common and well-known procedure is called medialization thyroplasty, or thyroplasty type 1 according to Isshiki. This surgery is used to treat a condition called glottic insufficiency, which can cause voice problems. Even though this type of surgery was first successfully performed in Germany in 1915, it is still not widely used in the country.

FAQs

  1. What is the main purpose of the surgery that modifies the structure of the larynx?
  2. What is medialization thyroplasty, or thyroplasty type 1, and what condition does it treat?
  3. Why isn’t the surgery that was first successfully performed in Germany in 1915 widely used in the country today?

Doctor’s Tip

A doctor might tell a patient undergoing vocal cord surgery to follow post-operative care instructions carefully, such as avoiding speaking loudly or whispering, staying hydrated, and avoiding irritants like smoke. It’s important to give your vocal cords time to heal properly for the best possible outcome.

Suitable For

Patients who are typically recommended vocal cord surgery are those who have:

  1. Vocal cord paralysis: This can be caused by nerve damage, trauma, or other medical conditions, and can lead to difficulties in breathing, swallowing, and speaking.

  2. Vocal cord nodules or polyps: These are noncancerous growths on the vocal cords that can affect voice quality and cause hoarseness.

  3. Vocal cord cysts: Fluid-filled sacs that can develop on the vocal cords and cause voice problems.

  4. Vocal cord tumors: Both benign and malignant growths on the vocal cords may require surgical removal.

  5. Laryngeal stenosis: Narrowing of the airway in the larynx can cause breathing difficulties and may require surgical intervention.

  6. Vocal cord scarring: Scar tissue on the vocal cords can affect voice quality and may require surgical treatment to improve function.

  7. Chronic laryngitis: Long-term inflammation of the vocal cords can lead to voice problems that may necessitate surgical intervention.

Overall, vocal cord surgery may be recommended for patients who have persistent voice problems that have not improved with conservative treatments such as voice therapy or medication. It is important for patients to undergo a thorough evaluation by an otolaryngologist (ear, nose, and throat specialist) to determine the underlying cause of their voice issues and to determine if vocal cord surgery is the appropriate treatment option.

Timeline

Before vocal cord surgery:

  1. Patient consults with an otolaryngologist or a speech-language pathologist to determine the need for surgery.
  2. Patient undergoes a series of tests and evaluations to assess vocal function and determine the best course of treatment.
  3. Patient receives information about the surgery, including potential risks and benefits, and prepares for the procedure.

After vocal cord surgery:

  1. Patient undergoes the surgical procedure to modify the vocal cords.
  2. Patient may experience temporary hoarseness, throat pain, or difficulty swallowing immediately following surgery.
  3. Patient receives post-operative care instructions and may need to follow a specific voice therapy program to optimize vocal outcomes.
  4. Patient attends follow-up appointments with their healthcare provider to monitor healing and vocal function.
  5. Patient gradually resumes normal voice use and activities as directed by their healthcare provider.
  6. Patient may experience improvements in voice quality and function as the vocal cords heal and adjust to the surgical changes.

What to Ask Your Doctor

  1. What specific procedure are you recommending for my vocal cord surgery?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time and post-operative care for this procedure?
  4. How will this surgery improve my voice quality and overall vocal function?
  5. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  6. How experienced are you in performing this type of surgery?
  7. What is the success rate of this surgery for patients with similar conditions to mine?
  8. Will I need any speech therapy or vocal rehabilitation after the surgery?
  9. How long will the effects of the surgery last, and are there any potential long-term effects to consider?
  10. Are there any lifestyle changes or modifications I should make before or after the surgery to optimize the results?

Reference

Authors: Hess M, Fleischer S. Journal: HNO. 2021 Sep;69(9):726-733. doi: 10.1007/s00106-021-01054-9. Epub 2021 May 12. PMID: 33978776