Micro-Laryngeal Surgery is done to address problem in the vocal chords or a voice disorder. This is a Minimally Invasive Technique that helps in the correction of the voice disorder or problem in the larynx. It involves the removal of the unwanted and unnatural growth in the larynx such as cysts or polyps that may not respond to more conservative treatment and needs surgery.
BRIEF ABOUT THE PROCEDURE
These are instruments used to bring the vocal folds into view. The laryngoscope is inserted into the mouth and passed down the throat until it sits just above the vocal folds. In the ideal situation the entire length of the vocal folds will be easily seen without much force on the laryngoscope. The surgeon can then use instruments in his right hand, working through the laryngoscope. The operating arrangement is useful for inspecting the throat and getting an overall view of the larynx. However, for actual surgery on the vocal folds a more magnified view is necessary.
Microscopes and Telescopes
Delicate surgery on the vocal folds is best done under high magnification. Special operating Microscopes and Endoscopic telescopes are used to magnify the folds during surgery. The microscope has a large focal length and binocular eyepieces that allows a good three-dimensional view of the folds. One drawback with the microscope is that, since surgery is done through the narrow laryngoscope, the upper parts of the various surgical instruments can block one’s view. Special laryngeal telescopes can, in contrast, be placed just above the vocal folds and give unobstructed views of the folds.
Various manufacturers offer specialized instruments used for operating on the larynx. These instruments have a variety of different tips for grasping, cutting, or dissecting tissue. They have to be long and narrow since all surgery is done through the laryngoscope. The ends must be very small, usually only 1 or 2 mm, since the structures on the vocal folds are also tiny.
Anesthesia for Surgery
Almost all microlaryngeal surgery is done under general anesthesia. The patient must be anesthetized strongly enough so that he does not gag with the laryngoscope in place, so that he doesn’t feel anything, and that he have no memory of the surgery.
SOME ASSOCIATED RISKS
Microlaryngeal surgery is extremely safe. Like any surgery, there are some risks. There are slight risks of general anesthesia, especially in individuals with severe heart or lung problems. Specific risks from the laryngoscope include pain and numbness to the tongue due to pressure (fairly common), some bruising to the lips (also relatively common), and in a worse case scenario, a chipped tooth (quite rare, but still possible if it is hard to see the vocal folds).