Laser Micro : Laryngoscopic Surgery

What is micro laryngeal surgery?
Micro laryngeal surgery, is a minimally invasive procedure used to correct voice disorders, speaking or breathing difficulties or other problems affecting the larynx.

The larynx is located in the front of the neck and helps us breathe, swallow and speak as it controls the opening and closing of the windpipe The larynx is also where the vocal cords are found.

What is the indication for micro laryngeal surgery?
Microscopic voice surgery may be determined to be the best course of treatment after diagnostic testing and examinations have discovered the source of a persistent cough, hoarseness or various voice problems.

Sound that comes from the vibration of the vocal cords is the primary source of speaking and singing. The lining of the vocal cords is the mucosa. Any lumps, bumps, or irregularities on or underneath the vocal cord mucosa can make it vibrate abnormally and cause a voice change. Vocal cord polyps, nodules, cysts, and papilloma are some of the benign lesions that can develop on the vocal cords.

The treatment of vocal cord lesions depends on the nature of the problem and the degree of voice change Medications, speech therapy and laryngeal microsurgery are the more common types of treatment for these conditions and may be used alone or in combination Microsurgery is recommended after accurate ear, nose and throat assessment and consideration of the specific voice disorder


What is the procedure for micro laryngeal surgery?
General anesthesia is required when a patient is undergoing microscopic voice surgery. Once it has taken effect, the laryngoscope is properly placed in the patient’s mouth and navigated into the throat. Next, the surgical tools are inserted through the laryngoscope and directed into the larynx to reach the vocal folds. Making use of the instrument’s high magnification capabilities, the surgeon approaches the area in which the growth has been identified with precision and care.

Once the lesion that has formed on the surface of the vocal fold is reached, it will be cut away and completely removed with the Laser as well as surgical cutting tools. This technique allows for incredible accuracy in order to ensure that only the damaged tissue is removed and the surrounding area remains unaffected. By leaving the majority of the laryngeal structure intact and completely unharmed, microscopic voice surgery is a minimally invasive technique that offers a rapid healing process The Lumenis Co2 laser is available at our centre and is one of the world’s most advanced lasers.
It's advantages are:

• Precise incision, excision and vaporization, with microvascular homeostasis
• Predictable, reproducible laser- tissue interaction
• Minimal thermal damage for excellent tissue margins
• Minimal disturbance to structures, nerves and tissues
• Quicker recovery time and shorter hospital stay

Following the procedure, you will be monitored for several hours then released to return home the same day. Most patients experience some level of discomfort after the surgery, but it will often respond well to over-the-counter pain relievers such as acetaminophen or ibuprofen. If your pain is more significant, a stronger form of medication can be prescribed for short-term use. Cough medicine may be recommended as well to ensure that you do not irritate the sensitive tissue of the larynx as it recovers.
What are the risks of micro laryngeal surgery?
While microscopic voice surgery is considered a safe procedure, all forms of surgery do carry some risk. Although rare, the complications that are associated with microscopic voice surgery include a reaction to anaesthesia, dental damage, temporary numbness of the tongue, bleeding, infection and less than optimal results. Choosing a physician with extensive experience in microscopic voice surgery can help lower the risk of encountering any difficulties.
What about using my voice after the procedure?

• The duration of voice reset depends on the underlying problem and the demands you place upon your voice
• As a general guide voice rest for the first five days after surgery is recommended
• As the vocal cords heal talking in a normal conversational voice is best – whispering and speaking loudly or shouting are not advisable
• Singing may recommence after 2 to three weeks but limited to 20 minutes per day
• After 6 weeks following surgery usually no limitations in talking or singing are needed

What things should I be concerned about after microlaryngoscopy?
If you develop any of the conditions listed below or have other concerns you should visit your local doctor or local emergency room who will contact your surgeon:

• Difficulty breathing
• Temperature above 38.5 degrees
• Persistent nausea and vomiting
• Persistent bright red blood in the saliva
• Difficulty eating and drinking or increase in throat pain

What should I expect after the procedure?

• A mild sore throat and mouth are common experiences after microlaryngoscopy
• There is often temporary hoarseness – voice improvement is usually gradual over weeks
• Nausea and a generally tired feeling are common after general anaesthesia and usually resolves within 24 to 48 hours
• A prescription for pain medicine, an antibiotic and anti-nausea medicine will be given as needed
• Plan to be off work at least until the first post-operative visit after around one week – a second visit is scheduled after around six weeks. You need to contact the office to confirm these appointments

Voice care tips
- Avoid whispering or shouting

• Avoid alcoholic drinks
• No smoking or smoky environments
• Limit telephone usage
• Keep your throat moist by sipping water or juice throughout the day and by chewing gum
• Allow for periods of vocal rest with no talking and no whispering
• Minimise coughing, hacking and throat clearing
• Use electronic amplification where necessary
• Do not attempt to speak over noise
• Rest your voice after singing, lecturing, etc.