Voice Surgery.

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Presentation transcript:

Voice Surgery

Phonosurgery

Anatomy & Physiology of the Voice Tract

Evaluation History Physical Exam Performance Evaluation Voice Laboratory

Surgery Patient Selection Informed Consent

Laryngeal Surgery

Endoscopic Surgery Indirect Laryngoscopy Elective Neck Percutaneous

Direct Laryngoscopy Anesthesia Local General

Instrumentation

Laryngeal Laser Surgery Carbon Dioxide

Laser Usage Advantages/ Disadvantages Uses

Laryngeal Laser Surgery Advantages 1) Hemostasis 2) Visibility 3) Tissue Manipulation

Laser Surgery Advantages: 1) Selected Lesions -varicosities -benign friable lesions on superior surface -other

Laser Surgery Disadvantages: 1) Loss of tissue 2) Thermal Injury 3) Laser fire

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

Nodules

Cyst Polyp Reinke’s Edema Papilloma Web Arytenoid dislocation Vocal fold paralysis Sulcus Volcalis Vocal fold scars

Reinke’s Edema

Papilloma

Carcinoma

Web

Hemorrhage

Scar

Sulcus Vocalis

“Bowed” Vocal Folds

Vocal fold paralysis

Arytenoid Dislocation

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