The vocal cords are two narrow folds of muscle covered with mucous membrane which are situated side-by-side inside the voice box or larynx, guarding the entrance to the windpipe.
They are mainly responsible for the production of sound. The folds vibrate as exhaled air from the lungs is passed through them, and this vibration brings forth sound, or voice.
The pitch of the voice depends on the frequency of these vibrations. In women and children, these cords are shorter and thinner than in men, resulting in higher-pitched voices.
Vocal cords may become damaged or strained, and are also subject to conditions such as growths and infection. The treatment of these conditions may require surgery.
Common surgical procedures on the larynx
Some examples of surgical techniques that may be used to treat disorders of the vocal cords are described below.
This procedure involves a detailed examination of the vocal cords under magnification, using a microscope or endoscope, or a video camera. While it is used for diagnosis, it is also employed with the objective of excising or removing a mass lesion from the vocal cords, such as a tumor or other swelling. Excision may be performed using lasers, or with long narrow endoscopic instruments.
The procedure is usually performed in an operating theatre but may also be done in the doctor’s office.
This is an external procedure that is used to provide support to bulk up or remobilize a vocal fold. It is most commonly used to treat a neurological problem such as laryngeal nerve palsy that is stopping one or both vocal folds from closing properly. Implants may be used to achieve the right position or bulk of the paralyzed immobile vocal cord. Voice therapy is required after the wound heals.
A reduction laryngoplasty is a procedure used to reduce the protrusion and height of the Adam’s apple. It is used to treat patients who desire a more feminine or even neck line. It was originally developed for transgender patients who desired to undergo treatment to help them become externally female.
Risks of vocal cord surgery
Like any surgery performed under anesthesia, vocal cord surgery carries its own risks:
anesthesia risks such as cardiac arrest, medication reactions or hypotension: these are serious and may be life-threatening, but the risk is small and an emergency team is on hand to deal with such situations
infections: these do not usually occur in a sterile operating environment
haemorrhage from the operative site: this is rare unless the tumor is very vascular
pressure on the tongue from the laryngoscope causing numbness: this may persist for some weeks but normal sensation usually returns
unanticipated injury to the vocal cords
scarring of the vocal cords with permanent change in voice
Recovering from vocal cord surgery
For patients to benefit fully from their vocal cord surgery, it is important that they follow certain recommendations soon after surgery. Some of the important measures are described below.
Completely rest the voice
Doctors advise that patients rest their voice completely for the first three days after surgery. This means not singing, talking, or even whispering at all. In cases where people use their voice on a professional basis, such as for acting or singing, five days of complete voice rest is recommended.
Try not to clear the throat
Patients are advised to try swallowing rather than clearing their throat.
Eat and drink as usual
Patients can eat and drink as they usually would, but should keep caffeine intake to a minimum. If an individual has chronic or previously diagnosed acid reflux or indigestion, he should continue to take the usual medication, and avoid any foods that may exacerbate the condition.
Drink plenty of water
Drinking eight glasses of water a day is advised in order to keep the larynx hydrated and for symptomatic relief. It is common to experience severe dryness of the throat and larynx following surgery, but this should start to feel better after a few days.
Use steam inhalation
Inhaling the steam from a bowl of hot water for 5 to 10 minutes, with a towel placed over the head to tent the hot vapour, can help to significantly humidify the respiratory passages and relieve the discomfort of a dry throat.
Avoid smoking and drinking alcohol
During the three-to-five day period of complete voice rest, patients are advised to avoid drinking alcohol and smoking cigarettes. They should also avoid being around others who smoke.
Reviewed by Dr Liji Thomas, MD. References