Laryngology / Voice Clinic
Laryngology is the study of larynx or voice box.
Voice box is a unique organ that co-ordinates between breathing, talking and swallowing.If you notice any change in your voice for more than 2 weeks; it has to be addressed. We perform video laryngoscopy to visualize the voice box and assess its function while the patient is awake. Detailed examination of larynx, nasopharynx, oropharynx, and hypopharynx can help in diagnosis and treatment
Common conditions affecting this area are-
Hoarseness can be due to acid reflux, vocal cord nodules, polyps, granulomas or in some cases cancer of the larynx (voice box).We perform flexible laryngoscopy using topical anesthesia to diagnose the disorders involving the voice box. Patients can see the picture of their own voice box that helps to understand the problem. We use Olympus Flexible Fiber-optic Laryngoscope. It has the advantage of flexible angulation, high-resolution, and clear image avoiding the need for general anesthesia to make the diagnosis.
Hoarseness / change of voice can be due to-
Common conditions of the vocal folds are-
Vocal Cord Nodules - These are small swellings seen on both vocal folds commonly caused due to voice abuse. Treatment is speech therapy by a trained speech therapist to allow the vocal folds to function normally rather than banging on each other.
Vocal Cord Polyps / Cysts- These are swellings which occur either on one or sometimes both vocal folds. Surgical treatment is recommended if speech therapy and medications fail. Surgery is called microlaryngoscopy. It consists of excision of the lesion under general anesthesia using a microscope and specialized instrument..
Vocal cord Paralysis In this one or both vocal folds become paralyzed leading to change in voice. Choking/ coughing especially after eating food may also happen. This can lead to aspiration pneumonia and death. One has to be very vigilant about this symptom. Unilateral vocal cord paralysis with above symptoms can be corrected by medialization procedure.
Flexible Fibre-optic Laryngoscopy being performed in the OPD
Medialization of paralysed vocal fold is principally done in 2 ways-
1. If the vocal cord is paralysed for less than 6 months we use temporary material
2. If vocal cord is paralysed for more than 6 months we use permanent material to injection or perform thyroplasty. Bilateral vocal cord paralysis may need tracheotomy to bypass the upper airway obstruction.
We perform microlaryngoscopy which is a same day procedure for removal of lesions involving the vocal cord using microflap technique at our hospital.
1. Microlaryngoscopy : Vocal cord lesions that do not resolve with medical treatment or look suspicious for cancer need surgery. It involves removal of lesion using a direct laryngoscope such as a Dedo laryngoscope and a microscope for magnified vision. Precise removal of lesion without injuring normal healthy mucosa is a must. This technique is called micro flap technique that minimizes scarring and preserves the voice quality.
2. Medialization procedures : a. Microlaryngoscopy with vocal cord injection.
It involves injecting temporary or permanent material by the side of the paralyzed called to push it in midline. By doing this the opposite mobile vocal cord can meet the paralyzed cord in midline thereby improving the strength of patients voice and preventing aspiration.