What is Microlaryngeal Surgery?

Microlaryngeal surgery is a procedure that fixes problems in your throat using a microscope and very small tools (or lasers). This surgery is done while you are under general anesthesia (a medicine that makes you sleep during the surgery so you feel no pain). It is usually an outpatient procedure (a surgery that does not require an overnight stay) performed in the hospital. The surgery typically lasts about 30 to 45 minutes.

During the surgery, a small tube is placed in your throat to help keep your airway safe. Because the surgery is done through your mouth, there is a minimal risk of minor injury to your mouth or teeth. Problems such as tongue numbness or changes in taste are very rare.

What to expect:

The procedure of operative laryngoscopy involves the use of microscopes and other fine instruments and/or lasers to correct vocal cord or laryngeal problems. As such, it is necessary to go under a brief general anesthesia (less than one hour) for this type of surgery. The surgery is usually done on an outpatient basis. You should expect to go home about 2 to 3 hours after surgery, when all is well. It is occasionally necessary to keep a patient overnight for medications and observation. If this is your case, you will be notified when you schedule the surgery.

Before surgery:

It is important to follow these instructions before surgery, especially if you are a singer or a professional voice user.

1. Voice use. The vocal folds must not be vigorously used before surgery. This is to reduce the degree of inflammation and swelling before surgery. It is advisable to not use the voice in any professional capacity 48 hours before surgery. If it is necessary to use the voice professionally, as in shouting or loud singing, please check with us. It is all right to speak quietly but not excessively.
2. Vocal cord health. Reducing irritants to the throat is important. The use of cigarettes, alcohol, and non-essential drugs should be stopped 48 hours before surgery. Prescription drugs may be taken until the surgery unless otherwise specified. Please check with the office if you are on any naturopathic remedies and inhalation treatments and leave us a list.
3. Diet. A regular diet is advised. Milk, chocolates, peanuts (all oily nuts), coffee and spicy foods are to be consumed lightly. In order to prevent reflux, eat smaller meals filling stomach to only 80%. In addition, do not lie down or go to bed immediately after eating. Hydrate your throat by drinking plenty of water, at least 64oz of non-caffeinated beverages per day.
4. Medications. There may be preoperative medications given to you by our office before surgery. If so, please don’t forget to take them. Other medications prescribed by other physicians should be listed with our office. In general, these medications can be taken through the day of surgery. Your internist may need to make adjustments of blood thinner, lung, heart and diabetic medications. Please check with the office if there is any need for medication adjustments.

Recovering from Microlaryngeal Surgery

After the surgery

Your physician will call your family after surgery to go over some post-operative instructions. If your physician does not call after you are ready for discharge, please call (212) 580-1004 and we will reach the doctor for you.

Most people do very well after microsurgery and experience little to no complaints. Pain medication is usually not necessary but may be prescribed for your comfort. You can expect some throat discomfort after the surgery but usually not severe pain. The sensation of excessive phlegm, a need to clear the throat, ear discomfort, and added effort during swallowing may be present for a few days to weeks after surgery, but is usually gone quickly.

1. Voice use. Voice ability will be variable after surgery depending on the procedure. Do not be alarmed if the voice is better right after the surgery than 24 hours after surgery, since swelling from the surgery may take 24 hours before becoming maximal. If you are a voice professional, voice rest for 4 days is usually necessary before trying to speak. With the doctor’s permission on follow up, you may have enough voice to go onto modified voice rest for one week. To check if you are ready for modified voice use, you can do a sigh or gentle hum.... If there is an easily produced sound, you may use it at that pitch for speaking in a quiet room. Loud or stage whisper is not to be used. DO NOT force the voice. If you are a singer or voice professional, you must be checked at one week after surgery to determine if you are ready to go back to work. If you are on voice rest, carry an index card that says: Voice rest. Doctor’s orders. Thank you.
2. Diet. Unless otherwise instructed you may resume your preoperative diet. Please check the post-operative instruction sheet to see if there are any specific dietary restrictions related to your specific surgery.
3. Medication. The medications after surgery may include a brief course of antibiotics and antacids. Occasionally medication for pain is needed. You may use either Tylenol or Tylenol with codeine. Do not use aspirin containing products without checking with the office.
4. Activities. You may resume normal activity 24 hours after surgery with the following restrictions: No weight-lifting or grunting, no wind instrument playing, and no contact sports. Please use caution and avoid noisy environments where shouting may be necessary.
5. Precautions. Avoid coughing and aggressive clearing of the throat. Swallow plenty of water to soothe the throat. Non-caffeinated orange spice tea with a wedge of lemon and tablespoon of honey is soothing and will help to calm irritation and dryness. Smoking, alcohol and other non-prescription drugs are not to be used for one week after surgery.
6. Follow-up and return to normal voice use. Follow up is usually arranged at one week after surgery. If you have special requirements for work, you may be checked sooner. You may work with a voice therapist after the first post-operative period to get the voice going again in a healthy way. Please plan accordingly.