Diseases of the throat, larynx and tracheyLarynx microsurgery

A change in voice may appear during an upper respiratory infection. When the infection spreads to the larynx, swelling of the vocal cords, hoarseness and sometimes aphonia may occur. Hoarseness associated with an upper respiratory infection usually disappears after recovery. Voice changes that persist for more than 2 weeks without being associated with an infection require the consultation of a phoniatrician. Hoarseness of the voice may be the first symptom of more serious diseases – laryngeal malignancies, especially in smokers. It is important to see a doctor on time. If laryngeal cancer is diagnosed  early enough, it can be completely cured. 

Voice disorders can occur not only in adults but also in children. In childhood, in most cases, dysphonia (hoarseness of the voice) can appear in case of a loud scream (nodules appear as a result of their stronger closure). Hoarseness of the voice can accompany allergic diseases. However, with prolonged hoarseness of the voice in a child, a medical consultation is necessary. For examination of children, an elastic fibroscope with a thin camera is used, which is inserted through the nose. The examination takes a few minutes and is well accepted by the patient.   

It is important to remember – hoarseness of the voice that persists for more than 2 weeks is an indication for consultation with a laryngologist or phoniatrician. 

Phoniatrician consultation

Patients with voice hoarseness first of all consult an otolaryngologist. But in some patients, it is not possible to identify the cause of the hoarseness with a standard examination of the larynx. In such cases, it is necessary to consult a phoniatrician.   

Diagnostic methods:

In individuals with voice disorders, the larynx is examined using a laryngoscope, a special camera that magnifies the image of the larynx. Valuable information is provided by conducting stroboscopy – a study of the movement of the vocal cords under special lighting. Stroboscopy allows you to determine the cause of the hoarseness of the voice, even if the standard examination did not reveal pathology. The study also allows you to identify laryngeal malignancies at an early stage.  

Treatment: 

Often, voice disorders are treated with antibiotics or anti-inflammatory drugs, sometimes voice rehabilitation is needed, which is carried out by a phoniatrician. Voice rehabilitation consists of teaching correct voice formation and adequate vocal presentation. A variety of exercises is advised, selected individually depending on the needs of the patient and the cause of the voice disorder. Manual therapy is also carried out, a special massage that normalizes muscle tension of the larynx. Voice rehabilitation brings very good results to patients with functional voice disorders (disorders of  muscle tension of the larynx), during voice mutations in boys, paresis of the vocal cords after operations on the thyroid gland, psychogenic aphonia.

Microsurgery of the larynx refers to phonosurgical interventions aimed at removing abnormal tissues and restoring the voice. Indications for phonosurgical operations: 

  1. Chronic inflammatory changes in the larynx: Reinke’s edema; polyps of the vocal cords; vocal cord nodules cysts and grooves of the vocal cords; hypertrophic changes; post-traumatic changes. 
  2. Changes due to improper voice formation or after intubation:contact ulcers;granulomas;paresis of the vocal cords
  3. Removal of precancerous changes: leukoplakia; hypertrophy with hyperkeratosis; benign tumors such as papilloma. Surgical intervention is carried out under general anesthesia using an operating microscope and CO2 laser. The surgeon removes the abnormal tissue or injects hyaluronic acid into the vocal cord. The removed tissues are sent for histopathological examination. After the operation, it is necessary to maintain vocal rest for 7 to 10 days. After healing, voice rehabilitation is performed.
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