Phonomicrosurgery (phono + micro + surgery)
Highly specialized surgery to improve voice (phonosurgery) using microsurgical techniques and highly magnified views (microsurgery) in order to provide microscopic detail
Superficial Lamina Propria (“Reinke’s space”)
Top layer of the laminae propria that plays a key role in vocal fold vibration; loosely structured; located just underneath the cell lining (epithelium) covering the vocal fold
Key Role of Patient in Recovery of Voice Function
The results of phonomicrosurgery can be either improved or impaired by the patient.
- For example, if a patient has backflow of stomach fluids to the voice box (laryngopharyngeal reflux), the patient should carefully follow physician recommendations for the aggressive treatment of the reflux, especially during the perioperative period. (For more information, see Reflux Laryngitis.)
- For example, if the voice disorder results from voice “abuse” or excessive voice use, the patient must correct these voice behaviors to avoid delayed healing or relapse of the voice disorder.
- The patient must also address other aggravating factors, such as allergies, smoking, and other environmental factors, in order to ensure the best outcome.
Elimination of Bad Vocal Habits
Patients should design a plan for postoperative voice care with their surgeon and/or speech pathologist before the surgery. In some instances, patients may be instructed to perform certain exercises that will help eliminate bad voice habits after the surgery, thus promoting proper healing.
Voice rest is often prescribed for a certain period of time following phonomicrosurgery. It is always wise to limit voice use after surgery on the vocal folds. Talking, straining, and coughing can cause trauma to the vocal folds and can delay healing. Although strict/complete voice rest is often only necessary for a short time after surgery, it is advisable to limit voice use for an additional week or more.
Patients are often tempted to try out their voice soon after surgery – but this is a bad idea, since it might delay healing and might cause damage to the healing tissues.
Patients should not expect immediate results from many types of phonosurgical procedures because it may take some time for swelling to subside and healing to occur.
Patients must follow the voice care team’s specific recommendations for voice rest, vocal hygiene, and postoperative vocal tasks in order to optimize the outcome of surgery. (For more information, see Prevention.)
Patient education material presented here does not substitute for medical consultation or examination, nor is this material intended to provide advice on the medical treatment appropriate to any specific circumstances.
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