Voice restoration surgery

Patients with vocal cord weakness may have a weak, breathy voice and strained speaking. Vocal folds cannot close completely during swallowing, and the patient may also show coughing and choking while eating or drinking.

The partial injury to the recurrent laryngeal nerve due to trauma, surgery, viral infection are the most common causes of vocal cord paralysis or paresis. This nerve is responsible for controlling the intrinsic muscles of the larynx. Occasionally a stroke can develop a vocal cord paralysis.

The most effective treatment of vocal cord weakness is a thyroplasty on the side of the nerve injury. This can help correct vocal cord weakness. A small incision is made in the skin near the larynx. A small piece of thyroid cartilage is removed and a small block of silastic (medical grade plastic) is secured into the cartilage. This block acts as a shim that pushes the vocal fold to midline to improve vocal cord closure. A thyroplasty is a relatively quick and painless procedure and is usually performed under local anesthesia. This allows the surgeon to fine-tune the patient's voice by making minor modifications in the thyroplasty implant.

Prosthetic surgical voice restoration and management of tracheo-oesophageal puncture prostheses are routine part of comprehensive voice rehabilitation for those undergoing surgery for removal of the larynx (laryngectomy).
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