Treatments
There are treatments available at
the Voice Institute that are available almost no where
else. The cornerstone of voice rehabilitation surgery is
“laryngoplastic phonosurgery” that refers to plastic
surgery of the larynx to alter the voice. This type of
surgery was introduced in the United States by
Dr. Jamie Koufman in 1986, and she has done much to
evolve this voice technology since that time.
Voice Rehabilitation
Surgery (Laryngoplastic Phonosurgery, Laryngeal Framework
Surgery, Laryngoplasty, Isshiki Laryngoplasty )
The most important applications of laryngoplastic
phonosurgery are for rehabilitation of vocal cord
paralysis or partial paralysis. (Partial paralysis of the
vocal folds is common and is often diagnosed as vocal fold
weakness or bowing.) Vocal fold bowing is one of the most
common causes of vocal nodules and polyps. At VINY we
strive to fix the lesions on the vocal folds, as well as
the underlying cause.
Bilateral Medialization
Laryngoplasty (BML)
The most common of the procedures is called “bilateral
medialization laryngoplasty” (BML). BML is performed under
local anesthesia in the operating room and allows
straightening or strengthening of crooked or bowed vocal
folds to alleviate hoarseness, vocal fatigue and other
voice symptoms. This procedure does require an overnight
stay in the hospital; nevertheless, BML provides
tremendous benefit and voice imporvement for the majority
of patients with weak vocal folds from Bell’s palsy of the
larynx, prior intubation injuries, prior surgical
intervention, cancer, viral neuropathy, or simply the
aging process itself. After cancer surgery, laryngeal
injury, or chronic illness, the voice may become weak due
to vocal fold damage and scarring. In many cases, the
voice can be restored by rebuilding part of the vocal
folds or larynx.
Rare Laryngeal Diseases
We at VINY have extensive experience with rare laryngeal
disorders, including sarcoid, lupus, rheumatoid arthritis,
fungal infections, relapsing polychondritis, laryngeal
chondrosarcoma, and spasmodic dysphonia (SD).
Office-Based Laryngeal
Laser Surgery
Office-based laryngeal laser surgery is new and safe and
profoundly effective. It generally is preferred by
patients to traditional surgical methods. (See the
aticle entitled Unsedated, office-based, laryngeal laser
surgery: Review of 444 cases using three wavelengths)
Office-based surgery has many
advantages. These include:
-
No intravenous sedation or other
medication is needed
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Patients require no
postoperative recovery
-
Only anesthesia needed is
topical (spray) with a topical anesthetic
-
Biopsies can be obtained for
histology
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The actual operating time is
minimized (in most cases to under 15 minutes)
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Many procedures are actually
technically easier and safer in the office than in the
operating room
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There are tremendous time and
cost savings for the patient
Among the most exciting
applications are for laryngeal polyps and papillomas. At
this point, with confidence, we can state that these
in-office laser technologies with new lasers provide
superior results to any other method in many cases.
The real great advance of
in-office un-sedated laser surgery is there is no risk of
general anesthetic complications, it’s less invasive,
there are no large rigid metal endoscopes, and so there
are fewer complications such as airway problems, dental
injuries, or sore tongue. In terms of patient satisfaction
90% of patients who have had in-office, as well as in the
operating room procedures, prefer the in-office procedure.
Patient satisfaction is increased because of improved
comfort, safety, and outcomes, easy recovery, and no
significant loss of time from work or family.
Care of the Professional
Voice
Care of the professional voice itself is an art and not a
science. In addition to the medical problems that can
affect the voice of us all, there are specific
occupational hazards and unique problems that vocal
professionals experience. These include allergies,
exposure to environmental pollutants, ambient noise
problems, inadequate amplification, training and
inappropriate tessitura issues, over-scheduling, hormonal
influences, and psychological, stress-related problems.
Vocal professionals need medical
care that is appropriately customized, timely, and that
doesn’t compromise the long-term outcomes. In addition,
singers especially need enough time with their physicians
to understand and participate in their own treatment. At
VINY, we don’t have to rush to get to the next patient,
and treatment is comprehensive.
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