Phonosurgery – voice-improving surgery

Causes

A change in the voice presenting as persistent hoarseness, roughness or a quiet voice can have various causes. These include benign or malignant changes, inflammation or functional disorders. If the voice change cannot be resolved with medication, voice therapy or behavioural changes, surgery may be considered. This is particularly relevant for conditions such as laryngeal papillomatosis, vocal cord cysts and pronounced Reinke’s oedema. In cases of vocal cord paralysis, age-related changes or defects after surgery, improvement can be achieved by injecting a bulking substance (injection glottoplasty) to restore inadequate vocal cord closure. Botox injections can help with vocal cord spasms.

Treatment options

Surgery: Phonosurgery aims to improve voice quality through a minor surgical procedure on the vocal cords. This is often performed under general anaesthesia. A short metal tube is introduced through the mouth to the larynx, and changes are removed using grasping forceps, scissors or a laser under an operating microscope. To improve vocal cord function in cases of paralysis, various substances can be injected under microscopic guidance, including absorbable substances such as hyaluronic acid or hydroxyapatite and non-absorbable substances such as fillers.

After the procedure

After the procedure, inpatient monitoring takes place, and voice rest for about a week is often required to promote wound healing. Follow-up examinations assess voice quality after surgery.