MICRO-LARYNGOSCOPY

Microlaryngoscopy is a procedure done primarily to diagnose and treat the problems associated with larynx. It is an out-patient procedure performed through a surgical instrument called a laryngoscope that is placed through the mouth to expose the vocal folds. A microscope is used to examine the vocal folds in detail.

The larynx also called a voice-box, is the area at the top of the trachea (windpipe) that contains the vocal cords. These are responsible for creating the voice when the lungs drive air to the larynx and the vocal cords act as the tone generator by making a sound.

The mouth, lips and tongue act as the modifier which articulate this sound to create speech. The nose and sinuses give resonance to our speech. So, the vocal cords play an important role in our speech. This technique has both therapeutic and diagnostic applications.

Diagnostic Indications:

The problems associated with larynx is diagnosed with:

• Microscopic visualization of the larynx (voice box) in cases of hoarse voice that cannot be diagnosed by indirect or direct laryngoscopy.
• A biopsy of laryngeal lesions help diagnose the extent of damage and evaluation of laryngeal trauma.

Therapeutic Indications:

Microlaryngoscopy is used for:

• The removal of foreign bodies.
• Removal of vocal cord polyp, cyst and benign lesions, vocal cord nodules.
• Dilatation of subglottic stenosis.
• Vocal cord palsy - in which teflon paste is injected into the vocal cords.
• Insertion of laryngeal stent.
• Excision of leucoplakia.
• Endoscopic arytenoidectomy.

Procedure:

The procedure takes about 60-90 minutes performed under general anaesthesia. A laryngoscope is inserted into the patient's mouth moving past the teeth and the tongue of the patient to get a clear view of the larynx (voice box) and then using a microscope or an endoscope, a magnified view of the vocal cords is got.

Post-Operative Care:

The following care should be taken to minimize discomfort during the recovery period for quicker recovery:

• Get adequate rest for at least two days following the procedure.
• Rest your voice completely for 48 hours following surgery.
• Rest your voice as much as possible for at least 7-14 days after surgery to ensure adequate healing and recovery of the vocal cords.
• Take fluids to keep the body hydrated and take soft diet for a few days.
• Take pain medication (as prescribed by your physician) to get relief from post-operative pain and sore-throat.
• Notify your doctor immediately if you see bright red blood. Post-operatively during the first few days, one may cough up dark blood or blood clots.

Complications associated with the surgery As with the any other procedure, microlaryngoscopy is also associated with few risks and complications. General complications like vomiting, nausea, bleeding, infection and allergies to medicines or dressings are common.

There are few risks specifically associated with microlaryngoscopy, such as

Injury to teeth, lips and gums As the operation is done through the mouth by inserting surgical apparatus, there might be potential risk of damage to lips, gums, teeth and tongue. Dental injury may result in teeth being chipped, broken or dislodged.

Swelling of the tissues of the airway This may lead to difficulty breathing requiring the insertion of a breathing tube through the mouth and support with breathing until the swelling resolves. Rarely, a tracheostomy (insertion of a breathing tube through the neck) may be required.

Bleeding into the airway This may cause difficulty in breathing and may require the insertion of a breathing tube through the mouth, until the bleeding is controlled.

Collapsed lung (Pneumothorax) A small hole in the lung may happen. Air leaks out from the lung, causing the lungs to collapse. The lungs may come back by itself, or a tube may be inserted into the chest through the skin to remove the air from around the lung. This may need a longer hospital stay.

Voice change The larynx (voice box) or the nerves controlling the larynx may be injured by the instruments used for the microlaryngoscopy. The voice change may be persistent and not respond to further treatment.

Recurrence possible.

Why BSR Hospital?

BSR ENT hospital is well-known for its team of expert and experienced surgeons with a proven track record of successful surgeries since the past 40 years. With a patient-centric approach to treatment, the doctors and the staff ensure patient comfort and safety. The hospital offers quality treatment at cost-effective price so that every patient can afford the treatment they deserve.

Using the latest technologies and equipment, BSR hospital provides safe treatment solutions and necessary guidelines for quick recovery. The hospital is also backed by a complete range of diagnostic facilities for quick diagnosis and treatment, reducing the discomfort for the patient.