Vocal fold polyp, nodule, cyst
Vocal fold polyp
When polyps are made, the vocal fold can not close properly and the voice becomes breathy. Antiphlogistic treatment such as oral ingestion or medical inhalation may not be effective and in many cases surgery is necessary. After the operation, patients must not speak for 3-5 days and patients have to wait 3-4 weeks before they can begin to sing or use their voice greatly.
Vocal fold polyp surgery under general anesthesia
Surgery is performed under general anesthesia using a microscope (Images 1 and 2). This procedure can be performed on an out-patient basis, as the operation itself requires approximately 10 minutes, the time for general anesthesia is about 40 minutes, and recovery in the hospital is about 4 hours. However, upon the request of the patient, surgery can be done on an in-patient basis, in which case hospitalization is approximately 3 days.
Conscious Out-patient vocal fold polyp surgery using surface anesthesia
Our clinic conducts most polyp surgeries using surface anesthesia. The procedure is performed with the patient in a conscious state, sitting in a chair in the examination room. After the surface of the vocal cord is carefully anesthetized, a forceps is inserted under fiber-scope guidance and the polyp is removed. Unlike polyp surgery performed under general anesthesia, this procedure allows the state of the vocal cords to be monitored simultaneously, by requiring the patient to speak. Our hospital conducts most polyp surgeries following this method.
Please watch the vide below
Vocal fold nodule
The vocal fold nodule is a small bulge that appears bilatellaly. As the cause is mostly abuse of the voice, vocal cord nodules are common in women with vocally demanding occupations (nursery school teachers, singers, etc.).
Rehabilitation of vocal fold nodules (correction of vocalization)
Because improper vocalization creates a burden on the vocal folds, proper vocalization is essential and can often be achieved with speech therapy, which also greatly improves the symptoms arising from vocal cord nodules.
Surgical treatment of vocal fold nodules
Surgery is carried out in patients with whom speech therapy did not result in improvement, and in patients requiring rapid recovery (for example, singers with a concert in the next few weeks). Surgery is performed under general anesthesia. Since the procedure is a delicate one, out-patient surgery under local anesthesia is not recommended, unlike surgery for vocal cord polyps. However, in a few cases it may be possible, depending on the shape or size of the nodule.
For conscious outptients surgery, please refer to the information describing vocal cord polyp surgery. Use of the voice should be completely avoided for 3–5 days after surgery, and speaking loudly, including karaoke and occupational voice usage (singing, voice lessons, telephone use, etc.), for 2–3 weeks.
Surgical treatment of vocal fold cyst
The vocal cord cyst is not common like polyps or nodules. In our clinic, we treat over 10 of these cases a year. Most institutions remove the cyst under general anesthesia because it is said that complete removal of the cyst is necesssary to prevent cyst recurrence. Also, vocal cord cysts are very fragile, and once they collapse, complete removal becomes difficult. The cyst recurrence rate following incomplete cyst removal is 10–20%. However the complete removal of the cyst, which many surgeons believe to be "the best way", may damage the vocal cord mucosa, and sometimes may even cause permanent deterioration of the voice.
At the Shinjyuku Voice Clinic, the cyst is opened using an endoscope and both the cyst wall and the surrounding vocal cord mucosa are resected. This surgery can be done using surface anesthesia, with the patient sitting in a chair in the examination room. Upon the patients' request, of cource we can do the same procedure under general anesthesia. We have performed this type of surgery to 117 patients and there have been no cases wherein the postoperative voice became worse. Recurrence developed in only three patients (2.5%, as of June 30, 2018).
1M after treatment