Voice Surgery



What is Voice Surgery?

Suspension microlaryngoscopy is the primary treatment for a large number of lesions of the voice box. Polyps, cysts, scar tissue, and sometimes nodules can be resected under high power magnification. Specialised techniques of micro flap excision minimise surrounding damage to the vocal cords and allow for excellent healing with return of the normal singing or speaking voice.

There are minimal complications and little discomfort from the surgery. Voice rest is typically required for 1 week after surgery. Voice therapy with a specialized speech pathologist with a classical singing background is essential both before and after surgery for full recovery with an optimal performing voice.

The Surgical Procedure

Voice Lift Surgery is surgery designed for the aging voice. As we age, so do our vocal folds. They become weak, atrophy, and as a result, vocal quality deteriorates.  In addition, constant overuse, abuse, and misuse, especially seen in voice professionals, speakers, and older people can lead to a decreased vocal quality. 

Now there is a way to help restore our voices to a more natural, youthful, relaxed quality. The Voice Lift involves an injection of implant material into the lateral part of the vocal cord.  This helps add increased substance to the vocal cord and diminishes the effort needed to obtain vocal fold closure and thus voice. This is performed in the consulting room under topical anaesthesia, or in the hospital setting.

Method

Microlaryngoscopy is a procedure that means the vocal folds are looked at in great detail with magnification. The magnification may be with a microscope, endoscope or by video enlargement. It is often accompanied by some additional procedure such as removal of a mass, swelling or tumour. Long delicate instruments or a laser may be utilised. It is sometimes performed in the consulting rooms, though more typically it is performed in the operating room.

Vocal fold injection is used to treat unilateral vocal fold paralysis by injecting material into the paralysed vocal fold. This pushes the paralysed fold to the middle so that when the normal fold closes there is no gap. For this procedure the patient is put to sleep with a general aesthetic and a special scope is put into the throat so that the injection can be performed. There are several things that can be used for vocal fold injections, these include your own fat or synthetic materials. Some injections can be performed with local anaesthesia.

Thyroplasty is a surgical technique designed to improve the voice by altering the cartilages of the larynx (the voice box), which houses the vocal folds (the vocal cords) in order to change the position or length of the vocal folds. TransNasal Esophagoscopy (TNE) is a technique of endoscopically examining the oesophagus with an ultra thin flexible endoscope that is passed via the nose into the oesophagus.

What to expect after surgery

Vocal Fold mediatisation surgery can help to close the voice box, provide a stronger, more natural voice, and help prevent aspiration. This can be accomplished by an injection of material into the vocal folds to help push them together. This injection is either performed in the consulting room under topical anaesthesia, or in the operating room.  Another procedure requires a small incision over the Adam's apple and the placement of a small implant to push the paralysed vocal fold toward the midline. Both are short surgeries, easily tolerated, and often with a great result.

If you are concerned about your voice please take the time to make an appointment to discuss this further with Dr Mooney on (02) 9389 4497 or use our Online Inquiry Form to talk further with our Patient Coordinator.

Ten Top Tips to a Healthy Voice

1. Use your voice well! Learn to optimise healthy voice production.  If you do a lot of talking or singing, learn to produce voice well - without strain or damage.

2. Keep your voice well hydrated! Adequate hydration is very important for healthy voice and vocal holds.  Drink at least 2-3 litres of water per day.

3. Warm up your voice! (As you would the rest of your body) if you're going to embark on prolonged singing or talking (for those who are teachers, speakers, or call centre operators).

4. Be wary talking or singing above background noise.  This can strain your voice so you need to recognise and avoid high risk situations.

5. Dont smoke and avoid smoky environments.

6. Don't repeatedly clear your throat and avoid coughing excessively!  These activities damage your throat.

7. Consider using amplification (microphone or megaphone) where loud voice is necessary.

8. Certain medications and drinks can dehydrate your voice.  These include antihistamines, cold and flu medications, coffee and alcohol.  Take these into account when talking or singing.

9. Don't scream or shout!  Using loud voice without damage requires special skills.  If you have to use loud voice, get specialist training from a voice trainer or speech pathologist.

10. Especially look after your voice during allergies and upper respiratory tract infections!  Your voice is more susceptible to damage at these times.

Remember it's important to seek evaluation and advice from an Ear, Nose and Throat Specialist if your voice is hoarse or husky for more than a few week, particularly if you smoke or don't have cold symptoms.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Sourced from The Australian Voice Association