FAQ’s

The voice is a key element in daily life, not only as an irreplaceable communication instrument in every activity of the human being, but also as a way of artistic expression. Those who use their voice as a working instrument (teachers, singers, preachers, speakers, politicians, actors, lawyers, etc. ) know the importance of maintaining a good quality voice in order to accomplish their professional activities without limitations.

Any change in voice characteristics deserves proper evaluation. Common symptoms are: Hoarseness, pitch changes, tiredness when speaking or singing, effort to produce voice, reduction of loudness, escape of air, tremor, spasms or voice breaks, pain while speaking or singing or emission of more than one sound. In all cases of voice disorders it is advisable to follow an ordered and efficient diagnostic process with the aim of precisely determining the cause of the problem.

At the Instituto de Laringología we have the knowledge, the professional experience and state of the art technology to perform a comprehensive evaluation of every single case.

Surgery of the voice, known as phonosurgery, is a relatively new subspecialty. Its development has come along with technological advancements in the diagnostic field (stroboscopy, high speed laryngoscopy, videokymography, high definition laryngoscopy), which have made it possible to perform better evaluation of the anatomy and function of the vocal folds. Phonosurgery includes a series of surgical techniques, most of them of microsurgery, and some others that require incisions in the neck, The purpose of them all is to improve the vibratory capacity of the vocal folds, condition that ensures the production of an adequate voice. Surgical interventions are not necessary in all cases in which lesions or structural changes of the vocal folds are found.

There are a good number of lesions that, although produce changes in the appearance of the vocal folds, do not affect their function, nor are malignant tumors and for that reason are not an indication for surgical treatment. It is imperative to keep in mind that any surgical intervention is a controlled trauma, and such trauma must be avoided whenever possible. Surgical treatment should only be considered in cases in which benefits of the intervention are clear and more important than risks.

Types of surgical interventions

Once a comprehensive evaluation of the condition of the vocal folds has been performed, and it is clear that there are important vibratory changes caused by any structural change or lesion that explains the presence of dysphonia, surgical treatment may offer benefits in properly selected cases.

Microsurgery

The vast majority of phonosurgical procedures can be carried out using a laryngoscope, which is a rigid tube that is placed inside the mouth and throat to allow access to the larynx in order to work on the vocal folds with micro surgical instruments with the aid of a microscope that magnifies the image so the surgeon has the possibility of observing even the smallest detail of the conditions of the structures.

Variability of the type of lesions that can be found is immense; most of them are benign, but it must be remembered that it is also possible to have cancer in the larynx. Differentiation among benign and possibly malignant lesions can usually be made by means of detailed endoscopic examination, although there are cases in which it is indispensible making biopsies to clarify the diagnosis.

By means of this approach it is also possible to perform injections on the vocal folds. This kind of procedures might be necessary in cases of unilateral vocal fold palsy caused by different problems such as thyroid surgery or trauma. Dr. Campos has a great deal of experience with autologous fat injection (fat obtained from the abdominal wall of the same patient). In properly selected cases that comply with several prerequisites, it is an excellent technique that ensures long lasting results with permanently stable voice quality.

In selected cases it might be necessary to perform interventions through incisions in the neck with the aim of modifying shape, size or position of the structures of the laryngeal framework to improve voice quality. The most common of these procedures is type I laryngoplasty, a technique that allows to push the vocal fold from the outside to improve its position.