Surgical Intervention Flashcards
What is microphonosurgery
Removal of pathological tissues
4 main groups of surgery
- Microphonosurgery (endoscopic removal of pathological tissue)
- Surgical correction of position, shape, and/or tension of VFs
- Surgergy directed at neuromuscular fn of VFs
- Surgical repair or reconstruction for partial loss and or laryngeal deformities
Surgical instrumentation
-Microscopes
-Lasers
What factors influence the decision making of surgical instrument use?
- Neck thickness
- Neck mobility
- Tongue size
- Mandibular arch dimensions
- Dentition
- Mandibular mobility
Lasers have been used for over 40 years… What is the primary concern with them?
Thermal injury may extend beyond the target area (damaging adjacent tissues)
Healing time is longer than cold knife techniques
What are the surgical outcomes with cold knife techniques vs laser?
No significant differences in outcomes
Laser has longer healing time
How do lasers remove laryngeal tissue?
They generate energy of a specific wavelength with different effects on the tissue
What was the first laser used for laryngeal surgery? What is significant about this laser?
CO2 Laser
Energy can be passed in a straight beam to the larynx
4 Components involving the course of treatment for Microphonosurgery
- Preoperative condition
- Surgical removal in OR under anesthesia or in office
- Postoperative care (VITAL to final surgery outcome)
- Cooperation between the otolaryngologist and voice clinician
What is the goal of microphonosurgery
Voice restored to normal function
What is the typical rest period after microphonosurgery
3 to 5 days, but duration is debated
After microphonosurgery, individuals will be able to use their voice & the voice quality will be immediately improved
False
Gradual return of the voice use using modified vocal rest approaches adapted to the individual
T/F microphonosurgery is NEVER used for nodules
False
Surgery is indicated ONLY in extreme cases
Nodules should disappear spontaneously, and voice therapy is initial treatment
For smaller masses associated with VF polyps and Reinke’s Edema, what type of microphonosurgery is used?
Incisions, dissections, and trimmings with scissors
Mucosa is then retracted medially
When should behavioral intervention be used?
- NOdules
- Small, translucent polyps
- Misuse: vocal hygiene/vocal behaviors
- Post-surgery to eliminate compensatory strategies, hard glottal attack, sencondary muscle tension
