1

Voice Surgery

2

Phonosurgery

3

Anatomy & Physiology of the Voice Tract

4

Evaluation

•History

•Physical Exam

•Performance Evaluation

•Voice Laboratory

5

Surgery

•Patient Selection

•Informed Consent

6

Laryngeal Surgery

7

Endoscopic Surgery

•Indirect Laryngoscopy

–Elective

–Neck

•Percutaneous

8

Direct Laryngoscopy

•Anesthesia

–Local

–General

9

Instrumentation

10

Laryngeal Laser Surgery

Carbon Dioxide

11

Laser Usage

•Advantages/ Disadvantages

•Uses

12

Laryngeal Laser Surgery

•Advantages

1) Hemostasis

2) Visibility

3) Tissue Manipulation

13

Laser Surgery•Advantages:

1) Selected Lesions

-varicosities

-benign friable lesions on superior surface

-other

14

Laser Surgery

•Disadvantages:

1) Loss of tissue

2) Thermal Injury

3) Laser fire

15

Laryngeal Laser Surgery

• Conclusions:

1) Valuable addition

2) Hazards preclude injudicious use

3) Fully educated team

4) Adequate tissue sample

5) On vibratory margins, use only when there is clear advantage over traditional methods

16

Nodules

17

• Cyst

• Polyp

• Reinke’s Edema

• Papilloma

• Web

• Arytenoid dislocation

• Vocal fold paralysis

• Sulcus Volcalis

• Vocal fold scars

18

Reinke’s Edema

19

Papilloma

20

Carcinoma

21

Web

22

Hemorrhage

23

Scar

24

Sulcus Vocalis

25

“Bowed” Vocal Folds

26

Vocal fold paralysis

27

Arytenoid Dislocation