Description
Phonosurgery plays a vital role in the management of voice disorders that significantly impact communication and quality of life. This session will provide an overview of the clinical indications for phonosurgical interventions and the various surgical techniques used to restore optimal vocal function. The webinar will also highlight patient selection, perioperative considerations, and expected postoperative voice outcomes. Through practical insights and clinical perspectives, this session aims to help clinicians better understand when and how phonosurgical procedures can be effectively utilized in voice disorder management.
Summary Listen
- Voice is crucial for communication, learning, and expressing emotions. Problems with voice quality can significantly disrupt daily life. Procedures exist to improve voice quality by treating disorders affecting the vocal cords and larynx, allowing patients to regain a normal voice. Famous individuals like Amitabh Bachchan, Lata Mangeshkar, and Morgan Freeman highlight the importance of voice as a unique identifier.
- Abnormal voice quality, termed dysphonia, manifests as hoarseness, roughness, weakness, or changes in pitch and volume. Diagnosis involves understanding the quality of the voice and considering organic, functional, or neuromuscular disorders. Evaluation requires a thorough history, including onset, progression, profession, and potential contributing factors like upper respiratory infections, medications, or past surgeries.
- Phonosurgery, similar to a facelift for the voice, aims to enhance deteriorated voices due to aging, medical disorders, or professional voice strain. Candidates are carefully assessed after exhausting non-surgical options like neuromuscular retraining, speech therapy, psychiatric evaluation, and medication. Procedures range from surgeries to injections, requiring a multidisciplinary team including laryngeologists and speech language pathologists.
- Injection laryngoplasty offers a non-surgical alternative for vocal fold paralysis. Using materials like vaseline (replacing previously used options like aggro and radias), the procedure involves injecting material into the vocal cord to medialise it. Transoral or transcutaneous approaches can be used, with precut thyroid membrane puncture being a common method.
- Fat augmentation is another augmentation technique using harvested fat from the patient's body instead of hyaluronic acid. The procedure involves harvesting fat, breaking it down into smaller globules, and injecting it into the paraglottic space. A key tip is to slightly over inject, being cautious of post operative stridor.
- Beyond augmentation, other procedures include steroid injections for posterior nodules. Botox injections are utilized for spasmodic dysphonia. Muscle tension dysphonia can be addressed effectively with laryngeal exercises and psychiatric evaluation, potentially avoiding surgery.
- Surgical interventions include type 1 thyroplasty (medialization thyroplasty) for vocal cord paralysis, requiring precise measurements and implant placement for optimal voice quality. Type 3 thyroplasty is employed for pubophonia, sharpening and repositioning the thyroid cartilage to deepen the voice.
- Patient selection is paramount, emphasizing when *not* to perform surgery. A cautious approach is crucial, especially for professional voice users. Prioritizing non-surgical interventions, avoiding over correction, and understanding the permanence of vocal cord interventions are essential considerations in phonosurgery.
Sample Certificate
About the Speakers
Dr. Neha Sood
Dr. Neha Sood Director ENT & Cochlear Implant, BLK - Max Super Specialty Hospital, Delhi. Pro Health Specialists - Centre of Excellence in ENT Care & Cochlear Implants, Gurgaon
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