Phono Surgery

Phono Surgery: Advanced Voice Restoration and Enhancement

Phono Surgery refers to a group of highly specialized surgical procedures aimed at improving, restoring, or modifying vocal function by correcting structural or neurological abnormalities in the larynx (voice box). It combines precision surgical techniques with a deep understanding of laryngeal physiology and voice mechanics. At MicroCare ENT, we offer cutting-edge phonosurgical interventions tailored to each patient’s unique voice condition and professional demands

1. What is Phono Surgery?

Phono Surgery involves surgical manipulation of the vocal folds and surrounding laryngeal structures to improve phonation. It is typically indicated for patients suffering from hoarseness, vocal fatigue, breathy voice, or loss of vocal clarity due to anatomical lesions, paralysis, or vocal fold dysfunction.

2. Indications for Phono Surgery

Phono Surgery is recommended in the following voice-related conditions:

  • Vocal Fold Nodules– Bilateral, symmetrical thickening on the edge of the vocal cords due to chronic voice overuse.
  • Vocal Fold Polyps– Fluid-filled lesions typically caused by sudden vocal trauma.
  • Vocal Fold Cysts– Encapsulated lesions within the vocal fold layers that disrupt vibration.
  • Reinke’s Edema– Gelatinous swelling of the vocal cords, often seen in smokers.
  • Vocal Cord Paralysis or Paresis– Loss or weakness of vocal cord movement, causing hoarseness or aspiration.
  • Spasmodic Dysphonia– A neurological disorder characterized by involuntary spasms in the vocal cords during speech.
  • Sulcus Vocalis– A longitudinal groove on the vocal fold leading to weak and breathy voice.
  • Granulomas and Contact Ulcers– Inflammatory lesions often due to trauma, reflux, or intubation injury.
  • Laryngeal Papillomatosis– Recurrent, wart-like growths on the vocal folds caused by a viral infection.
  • Functional Voice Disorders– Disorders without structural lesions but requiring surgical intervention after failed therapy.

3. Types of Phonosurgical Procedures

Each type of Phono Surgery targets specific voice issues. Selection depends on the diagnosis, severity, and the functional goals of the patient.

 

3.1 Phonomicrosurgery

This involves precise surgical removal of benign lesions from the vocal cords under high magnification using microsurgical instruments.

  • Applications: Nodules, polyps, cysts, edema, papillomas.
  • Goal: Preserve the vibratory edge and the layered structure of the vocal fold.
  • Technique: Cold steel instruments or lasers (e.g., CO₂ laser) used to delicately remove the lesion without damaging healthy tissue.
  •  

3.2 Injection Laryngoplasty

This is a minimally invasive procedure where a bio-compatible substance is injected into the vocal cord to improve closure.

  • Indications: Vocal fold paresis, paralysis, age-related atrophy.
  • Materials Used:
  • Autologous fat
  • Hyaluronic acid gel
  • Collagen-based fillers
  • Benefit: Instant improvement in vocal power and clarity, often done under local anesthesia.
  •  

3.3 Medialization Laryngoplasty (Thyroplasty Type I)

A permanent solution to vocal cord paralysis, where an implant is placed through the thyroid cartilage to push the paralyzed cord toward the midline.

  • Advantage: Voice can be assessed and adjusted during the procedure itself as it is done under local anesthesia.
  • Outcome: Improved glottic closure, reduced breathiness, and enhanced projection.
  •  

3.4 Arytenoid Adduction

This procedure repositions the arytenoid cartilage to improve posterior glottic closure in cases where simple medialization is insufficient.

  • Combined With: Medialization laryngoplasty for best results in complex cases.
  • Indications: Posterior glottic gap, vocal fold fixation.
  •  

3.5 Laryngeal Reinnervation

This involves reconnecting or rerouting nerves to restore tone and bulk to the vocal fold muscles.

  • Best For: Young patients or those with long-term unilateral vocal cord paralysis.
  • Goal: Restore dynamic muscle control and long-term voice improvement.
  •  

3.6 Laser-Assisted Voice Surgery

High-precision lasers are used for superficial or vascular lesions of the vocal fold, offering clean cutting with minimal bleeding.

  • Indications: Papillomas, leukoplakia, small polyps.
  • Technology Used: CO₂ laser, KTP laser.

4. Phono Surgery in Professional Voice Users

At MicroCare ENT, we recognize that singers, teachers, speakers, and broadcasters rely on their voice for their profession. Phono Surgery in such patients demands:

  • Maximum tissue preservation
  • Precise lesion excision without scarring
  • Comprehensive pre- and post-operative voice therapy

Our tailored approach ensures that the tonal quality, pitch range, and endurance of the voice are preserved and enhanced.

5. Pre-Surgical Evaluation

Before planning surgery, a thorough evaluation is essential:

  • Videolaryngostroboscopy– To assess the mucosal wave and vocal fold vibration.
  • Voice Analysis– Using acoustic and aerodynamic measurements.
  • Perceptual Evaluation– Subjective voice assessment using standardized voice rating scales.
  • Imaging– If structural lesions are suspected, imaging (MRI/CT) may be advised.

6. Post-Surgical Voice Care and Rehabilitation

Recovery doesn’t end at surgery. A guided rehabilitation plan is critical for vocal recovery and protection:

  • Voice Rest: Typically for 5–7 days depending on the surgery.
  • Hydration & Vocal Hygiene: Encouraged to prevent dryness and irritation.
  • Speech Therapy: Begins after initial healing to restore proper phonation technique.
  • Gradual Return to Vocal Demands: Especially in professional voice users.

7. Benefits of Phono Surgery

  • Improved Vocal Quality– Clearer, stronger, and more stable voice.
  • Restored Communication Ability– Essential for personal, social, and professional interactions.
  • Enhanced Confidence– A stronger voice often leads to improved self-esteem.
  • Reduced Vocal Fatigue– Especially in patients using their voice extensively.
  • Permanent Relief– From persistent hoarseness or breathy speech in paralysis cases.

8. Why Choose MicroCare ENT for Phono Surgery?

  • Experienced Laryngologistsspecializing in voice disorders
  • Dedicated Voice Clinicsfor comprehensive diagnosis
  • State-of-the-Art Surgical Equipment
  • Customised Plansfor singers and professional speakers
  • Multidisciplinary Voice Therapy Teamfor full-spectrum care

 

Phono Surgery is a life-changing intervention for those who depend on their voice, or suffer from persistent hoarseness and vocal dysfunction. At MicroCare ENT, we combine surgical precision with compassionate, tailored care to restore your voice and improve your quality of life. If you’re experiencing voice changes or vocal fatigue, consult our voice care team today and take the first step toward confident communication.

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