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Office based laryngeal surgery for hoarseness and voice disorders

Office based laryngeal surgery for hoarseness and voice disorders

Voice Disorder

Voice disorders are frequently encountered at otolaryngologic clinic. While benign laryngeal lesions, such as vocal fold nodules, polyps, and cysts, are usually resulted from vocal overuse or misuse, unilateral vocal fold paralysis is common in patients receiving thyroid or chest surgery. These disorders can result in loss of air through the vocal folds during phonation and have a significant impact on the patients’ quality of life.

 

What is an office-based laryngeal surgery?

Traditionally, laryngeal surgeries are performed in operating room. However, these procedures carry the risk and expense of general anesthesia. Office-based laryngeal surgeries are new treatment options to manage voice disorders. Percutaneous corticosteroid injection can be used to treat vocal fold nodules, polyps, and cysts with good results, and injection laryngoplasty delivers filler into the paralyzed vocal fold and improve glottic closure. Both of them also hold the advantages of low invasiveness and minimal morbidity.

 

How is it done?

At the outpatient clinic, injection is performed with the patient seated on a conventional examination chair. Before the procedure, the nasal cavity, pharynx, and larynx of the patient are anesthetized with lidocaine topical spray. A flexible nasopharyngoscope is passed transnasally into the laryngeal introitus by an experienced assistant, maintaining a stable magnified image of the vocal folds on a video monitor. For patients with benign vocal fold lesions, corticosteroid is injected into the submucosal layer of the lesion. For those with unilateral vocal fold paralysis, either autologous fat or hyaluronic acid is injected into the paralyzed vocal fold. Voice rest for 3 days is suggested after the vocal fold injection.

 

Why is it done?

The response rate of percutaneous corticosteroid injection for vocal fold nodules, polyps, and cysts is about 90%. Symptoms of unilateral vocal fold paralysis, such as weak voice and easy choking, can be improved after office-based injection laryngoplasty.

 

Risks & complications

  1. Temporary voice change because of submucosal deposit of the injected corticosteroid or ecchymosis.
  2. Temporary vocal fold atrophy in less than 1% of the patients receiving corticosteroid injection.The atrophy usually recovers spontaneously in several weeks.
  3. Patients with severe medical diseases or hypersensitive laryngeal reflex are not suitable for office-based laryngeal procedures.

 

 

 

Estimated Cost

For estimated medical costs, please contact International Medical Services Center.

 

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