Micro laryngeal surgery (MLS) is a specialized surgical procedure that allows precise, minimally invasive treatment of disorders affecting the larynx (voice box). Utilizing a surgical microscope and fine instruments introduced through the mouth, MLS enables surgeons to remove lesions, repair vocal cords, and treat a variety of laryngeal pathologies while preserving voice quality and airway function.
This technique is widely used to treat benign vocal cord lesions such as polyps, nodules, cysts, papillomas, and early-stage laryngeal cancers. It offers excellent visualization, minimal tissue trauma, and quick recovery, making it the preferred option for many laryngeal conditions.
This comprehensive guide will discuss the causes and risk factors prompting micro laryngeal surgery, symptoms and signs indicating the need for intervention, diagnostic processes, treatment options, prevention and postoperative management, potential complications, and living with conditions treated by MLS.
Benign Vocal Cord Lesions:
Vocal nodules, polyps, cysts, and granulomas causing hoarseness or voice fatigue.
Recurrent Respiratory Papillomatosis (RRP):
Wart-like growths caused by human papillomavirus (HPV) infection, leading to airway
obstruction.
Early Laryngeal Cancer:
Early glottic carcinomas amenable to local excision.
Vocal Cord Paralysis or Scarring:
MLS can help in medialization or scar revision.
Laryngeal Stenosis or Webs:
Narrowing or web formation in the vocal cords.
Foreign Body Removal:
Removal of laryngeal foreign bodies or lesions obstructing airway.
Voice Abuse or Overuse:
Excessive or improper voice use leading to vocal cord trauma.
Smoking and Alcohol:
Increase risk of laryngeal lesions and malignancy.
Human Papillomavirus Infection:
Particularly subtypes causing papillomas.
Chronic Laryngitis or Reflux Disease:
Leading to mucosal irritation and lesions.
Occupational Exposure:
Exposure to inhaled irritants, dust, or chemicals.
Persistent Hoarseness:
Voice changes lasting more than two weeks.
Voice Fatigue:
Difficulty sustaining voice or speaking loudly.
Breathiness or Weak Voice:
Indicative of vocal cord lesions or paralysis.
Stridor or Noisy Breathing:
May indicate airway obstruction from papillomas or webs.
Throat Discomfort or Foreign Body Sensation.
Coughing or Frequent Throat Clearing.
Difficulty Swallowing or Pain:
Rare but may indicate deeper pathology.
Detailed History:
Duration, severity, and progression of symptoms.
Voice Evaluation:
Perceptual and acoustic analysis by speech-language pathologists.
Laryngoscopy:
Flexible or rigid endoscopy to visualize vocal cords and laryngeal structures.
Videostroboscopy:
Visualizes vocal cord vibration, useful for subtle lesions.
CT or MRI:
Used if malignancy or deep tissue involvement suspected.
Biopsy:
During laryngoscopy, if malignancy is suspected.
Microlaryngoscopy:
Performed under general anesthesia.
Use of Operating Microscope:
Provides high magnification and illumination for precise surgery.
Fine Instruments:
Micro-scissors, laser fibers, and micro-forceps used to remove lesions or repair
tissue.
Laser Surgery:
CO2 lasers often employed for precise cutting with minimal bleeding.
Voice Preservation:
Surgery is performed with utmost care to minimize damage to vocal cords.
Voice Therapy:
Pre- and postoperative speech therapy improves outcomes.
Medical Management:
Treatment of underlying causes like reflux or allergies.
Avoid vocal strain and abuse.
Smoking cessation to reduce risk of recurrence or malignancy.
Manage gastroesophageal reflux aggressively.
Protect voice in occupational settings.
Voice rest initially (usually 3-7 days).
Gradual voice rehabilitation with speech therapists.
Follow-up laryngoscopic examinations to monitor healing.
Use of humidifiers and hydration.
Early intervention if signs of recurrence or complications appear.
Bleeding:
Usually minimal; may cause temporary discomfort.
Infection:
Rare with proper sterile technique.
Scar Formation:
May lead to vocal cord stiffness or webs.
Voice Changes:
Temporary hoarseness or vocal fatigue common; permanent changes rare.
Airway Edema:
Swelling causing temporary breathing difficulty.
Granuloma Formation:
Inflammatory tissue growth at surgical site.
Anesthesia Risks:
Related to general anesthesia.
Most patients regain excellent voice function post-surgery with proper care.
Voice therapy plays a crucial role in rehabilitation.
Lifestyle modifications such as hydration, smoking cessation, and vocal hygiene improve long-term outcomes.
Regular ENT follow-ups are important to detect any recurrence.
Psychological support for patients experiencing anxiety about voice changes.
Micro laryngeal surgery (MLS) is a minimally invasive surgical procedure performed using specialized microscopes and delicate instruments to treat vocal cord lesions and other abnormalities of the larynx (voice box).
It is commonly performed to remove vocal cord polyps, nodules, cysts, papillomas, early-stage cancers, or other benign and malignant lesions affecting the vocal cords.
Under general anesthesia, a laryngoscope is inserted through the mouth to access the vocal cords. Using a surgical microscope and fine instruments, the surgeon carefully removes or repairs the lesion while preserving healthy tissue.
The procedure is done under general anesthesia, so it is painless during surgery. Postoperative discomfort such as a sore throat or hoarseness may occur but typically resolves within days to weeks.
Recovery varies but generally takes 1 to 2 weeks. Voice rest is often recommended for several days to weeks to allow healing.
Risks include bleeding, infection, vocal cord scarring, voice changes, and, rarely, airway obstruction. Most complications are uncommon and can be managed effectively.
Preparation includes a thorough evaluation, imaging studies, voice assessment, and preoperative counseling. You may be advised to avoid eating or drinking before surgery.
Patients may experience a sore throat, mild pain, hoarseness, or cough. Voice rest and hydration are important. Follow-up visits are needed to monitor healing and voice quality.
The goal of MLS is to improve voice quality by removing lesions that impair vocal function. Most patients experience significant voice improvement after recovery.
Voice therapy is often recommended to optimize vocal recovery, retrain vocal techniques, and prevent recurrence of lesions.
The other ENT Procedures are:
Few Popular Hospitals for Micro-Laryngeal Surgery are:
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