Microlaryngoscopy is a procedure in which vocal cords are looked at in great detail with magnification using operating microscope. It is often accompanied by some additional procedure such as biopsy, stripping of vocal cord, removal of polyp or nodules and removal of a tumour and other lesion.
When microlaryngoscopy is performed in the operating room, it is usually done with the patient asleep-under General Anesthesia.
An instrument called a laryngoscope is inserted through your mouth so the surgeon can down your throat past the back of your mouth. The laryngoscope is a hollow metal tube that when placed in the proper position allows a direct view of your voice box. It pushes the teeth and the tongue out of the way. To protect your teeth from chipping, a rubber or plastic tooth guard is placed over your upper teeth. Your neck is extended so that the surgeon has a view straight down your throat from above.
Your eyes are closed and padded for protection. If the laser is used, wet towels are placed over and cover your face completely to absorb the laser beam if inadvertently fired. The surgery is delicate and a bit tedious but not difficult.
It may take about an hour to perform a typical surgery, though this varies a lot. Many types of procedures can be performed during a microlaryngoscopy. Some typical procedures would include using long delicate forceps to grasp and hold a nodule. Then microscissors are used to remove the bump. Sometimes fluid is injected into the vocal fold to push a surface bump away from the underlying structures before it is cut. The laser may be used to vaporize an unwanted blood vessel. A tumor may be cut out with the laser. Scar tissue may be cut with a knife, fat may be implanted, the incision in the vocal fold may be left open, and in uncommon cases, it may be sewn shut. A biopsy or small sample may be taken to find out what disease is present. I cannot personally think of an occasion to strip a vocal fold.
After the Procedure:
Absolute Voice Rest Is Required For 7 Days After Surgery. This means no talking or even whispering. Coughing and throat clearing should be avoided for at least 14 days.
If you require Speech Therapy after surgery, your first session will be about 2 weeks after surgery, with other sessions over the next several weeks as required.
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