Phonosurgery is undertaken to restore, change or improve voice. It can be in the form of injections, microsurgery or open surgery.
In phonomicrosurgery, pathology is evaluated carefully using rigid telescopes and an operating microscope followed by excision where dissection is limited to the most superficial plane possible preserving maximal amount of epithelium and lamina propria. As Phonosurgery can carry significant impacts on postoperative quality of life, the decision to proceed with surgery must be made carefully between the surgeon and patient, often involving a speech-language pathologist, patient's family members or voice trainers as well. Preoperative voice therapy will be indicated both to determine if the patient's voice complaint can be resolved without surgical intervention and to modify any potentially maladaptive behaviors that may adversely affect the surgical outcomes.
In combination with medical and voice therapies when necessary, as well as lifestyle changes when applicable, phonomicrosurgery can be effective in treating and improving the voice function of patients with the following voice disorders:
* Vocal Fold Nodules
* Vocal Fold Polyps
* Vocal Fold Cysts
* Vocal Fold Pseudocysts
* Vocal Fold Granulomas
* Vocal Fold Vascular lesions
* Vocal Fold Papillomatosis
* Vocal Fold Atypia or Leukoplakia
* Laryngeal Early cancers
* Vocal Fold Scarring (to some extent)
Phonomicrosurgery is typically performed as an outpatient surgery. Wide range of laryngoscopes and micro instruments are used for precise removal of a lesion with less scarring. Lasers ,laryngeal debriders and laryngeal coblators are also available for the same. Ascent Hospital provides the best phonosurgery treatment in calicut. Laryngeal framework surgery- alters vocal fold position,shape and tension by manipulating cartilaginous framework Types-
* Type I Medialisation- surgical augmentation and arytenoid adduction
* Type II Lateralisation
* Type IIIRelaxation/Shortening
* TypeIV Tensioning/lengthening
Vocal cord augmentation is performed for
* Vocal cord palsy
* Vocal cord paralysis
* Vocal cord atrophy
* Vocal cord scar
Vocal fold augmentation is done under local/general anaesthesia. Permanent or temporary injectable materials are used via per oral/percutaneous route. Lateralisation surgeries includes suture method (arytenoidopexy) and resection methods (arytenoidectomy, cordectomy) which are done in spasmodic dysphonia , vocal cord palsy. Type III thyroplasty aims at reducing vocal pitch. It is in males with high pitch voice resistant to voice therapy(puberophonia) in spasmodic dysphonia. Type IV thyroplasty helps to elevate pitch, in case of androphonia & male to female transsexualism.
Following phonosurgery Patients are typically placed on a period of absolute voice rest ranging from two to seven days depending on surgeon preference. During this time, patients should be instructed to maintain hydration and use steam inhalation several times a day to help keep mucus thin in order to avoid throat clearing or coughing.