Laryngeal Operations

An exploratory microlaryngoscopy is a procedure that allows your doctor to look closely at your voice box (larynx) and vocal cords using a special microscope. It is done under general anaesthetic (while you are asleep) and helps diagnose and sometimes treat problems like:

• Hoarseness or voice changes
• Growths, nodules, or polyps on the vocal cords
• Difficulty breathing or swallowing
• Persistent cough or throat discomfort

In some cases, the doctor may also take a small sample (biopsy) for further testing.

You may have been experiencing symptoms like:

• A hoarse or weak voice
• Ongoing sore throat
• Feeling of something stuck in the throat
• A lump in the neck or throat
• Problems speaking or swallowing

This procedure helps us see what’s going on and decide the best treatment.

• You will be given a general anaesthetic, so you’ll be asleep and won’t feel anything.
• A rigid tube (called a laryngoscope) is gently passed through your mouth to reach the voice box.
• A microscope and sometimes a camera are used to examine the area in detail.
• If needed, small tools can be used to take biopsies or remove small growths.
• The whole procedure usually takes 30–40 minutes.

Like all medical procedures, microlaryngoscopy has some risks, but serious complications are rare. Risks include:

• Sore throat or hoarseness for a few days
• Minor bleeding
• Damage to teeth or lips (very rare, but more likely if your teeth are loose or capped)
• Changes to your voice (usually temporary)
• Breathing difficulties (very rare)
• Infection (rare)

Your doctor will discuss the risks with you before the procedure.

• Do not eat or drink anything for 6 hours before your surgery (unless told otherwise).
• Let your doctor know if you take medications, especially blood thinners.
• Arrange for someone to take you home afterward—you won’t be able to drive.
• Remove any jewellery, dentures, or contact lenses before the procedure.

• You’ll wake up in the recovery area and be monitored for a short time.
• Most patients go home the same day.
• You may have a sore throat or hoarse voice for a few days.
• Avoid shouting or whispering—rest your voice as much as possible.
• Your doctor will arrange a follow-up to discuss any findings or biopsy results.

Contact your doctor or go to A&E if you have:

• Difficulty breathing or swallowing
• Bleeding from the mouth or throat
• High fever or signs of infection
• Severe or worsening pain

Injection laryngoplasty is a procedure where a special material is injected into one of your vocal cords (voice box) to improve your voice or help with swallowing. This is typically done when one of the vocal cords is weak or not moving properly, a condition called vocal cord palsy or paralysis.

The procedure is done under general anaesthetic, meaning you’ll be asleep and won’t feel anything during it.

You may have been experiencing symptoms like:

• A hoarse or weak voice
• Ongoing sore throat
• Feeling of something stuck in the throat
• A lump in the neck or throat
• Problems speaking or swallowing

This procedure helps us see what’s going on and decide the best treatment.

• You will be given a general anaesthetic, so you will be fully asleep.
• A rigid tube (laryngoscope) is passed through your mouth to access the vocal cords.
• A small amount of injectable material (e.g., hyaluronic acid, collagen, or another filler) is carefully injected into the weak vocal cord.
• The material adds bulk and helps the cords come together more effectively during speech or swallowing.
• The procedure typically lasts 30–45 minutes.

Different types of safe, body-compatible materials may be used. These can be:

• Temporary (e.g., hyaluronic acid) – often used for short-term or early treatment
• Longer-lasting (e.g., calcium hydroxylapatite) – for more sustained improvement
  

Your doctor will choose the most appropriate type for your condition and discuss it with you beforehand.

• Improved voice strength and quality
• Easier swallowing with less risk of food or drink going the wrong way
• Less breathlessness while speaking
• Often avoids the need for more invasive surgery

All procedures carry some risk, but serious complications are uncommon. Risks include:

• Temporary sore throat or hoarseness
• Swelling or bruising
• Over- or under-correction (may need repeat injection)
• Rarely, breathing difficulties or allergic reaction to the injection material
• Temporary worsening of voice as swelling settles

Your surgeon will explain these risks and answer any questions before you sign a consent form.

• No food or drink for 6 hours before surgery (unless told otherwise)
• Inform us of any medications, especially blood thinners
• Arrange for someone to drive you home or escort you after the procedure
• Let us know if you have any allergies, particularly to anaesthetics or fillers

• You will be monitored as you wake up from anaesthetic
• Most patients go home the same day
• Mild sore throat or voice change is normal for a few days
• Voice rest is usually recommended for 24–48 hours
• Avoid heavy lifting, shouting, or throat clearing
• You will have a follow-up appointment to check progress

Contact your doctor or go to A&E if you experience:

• Difficulty breathing
• Increasing pain or swelling in the throat
• Fever or signs of infection
• Bleeding from the mouth or throat

Microlaryngoscopy is a type of laryngeal (voice box) surgery performed under general anaesthetic to closely examine and treat problems affecting your vocal cords. A microscope is used for a detailed view of the vocal folds, and delicate instruments or a laser may be used to remove lesions such as a vocal fold polyp or cyst.

This is a day-case procedure, meaning most people go home the same day.

You may be offered microlaryngoscopy to:

• Remove a vocal cord lesion (e.g. polyp or cyst)
• Improve hoarseness, voice quality, or vocal fatigue
• Confirm a diagnosis via biopsy
• Relieve breathing or swallowing symptoms (in rare cases)

Lesions on the vocal folds can interfere with their vibration, affecting your ability to produce a clear voice.

• You will be given a general anaesthetic (you’ll be fully asleep).
• A rigid tube called a laryngoscope is placed through your mouth to access your voice box – no cuts are made on the outside.
• A microscope is used for magnified viewing.
• The lesion is removed carefully with fine instruments or a laser, depending on the type and location.
• The procedure usually takes 30–60 minutes.

Microlaryngoscopy is a safe and commonly performed procedure, but as with all surgery, there are some risks:

Common (temporary) side effects:

• Sore throat or mouth and numbness of the tongue for a few days
• Hoarseness or a weak voice while healing
• Mild bruising or swelling in the throat

Less common risks:

• Bleeding
• Infection
• Damage to teeth or gums (rare, as teeth may be protected during the procedure)
• Scarring of the vocal cords, which may affect voice quality (rare)

Your surgeon will discuss your specific risks in more detail before the operation.

• Most patients go home the same day.
• Voice rest is usually advised for a few days  — your surgeon or speech therapist will guide you on how long.
• You may be referred for voice therapy as part of your recovery.
• Avoid whispering, throat clearing, smoking, and straining your voice during healing.
• Full recovery of the voice may take several weeks, depending on the lesion and your voice use.

Contact your hospital or GP if you experience:

• Difficulty breathing
• Ongoing or heavy bleeding
• High fever or signs of infection
• Severe or worsening pain

You will usually have a follow-up appointment to:

• Review your healing
• Discuss any biopsy results (if a sample was taken)
• Plan any further treatment or voice therapy

Recurrent Respiratory Papillomatosis is a condition caused by the human papillomavirus (HPV), leading to wart-like growths (papillomas) in the larynx (voice box). These growths can affect the voice and, in severe cases, cause breathing difficulties.

Microlaryngoscopy is a procedure where a thin tube with a camera (laryngoscope) is inserted through the mouth to examine the vocal cords under a microscope. Debridement involves removing the papillomas using precise surgical techniques, such as:

• Microdebrider (a special instrument that carefully removes tissue)
• Laser surgery (often used to target the affected areas)
• Cold instrumentation (using small surgical tools to excise the growths)

The procedure helps improve voice quality, reduce airway obstruction, and slow the regrowth of papillomas.

Your doctor may recommend this procedure if you have:

• Hoarseness or voice changes due to papillomas
• Difficulty breathing or stridor (noisy breathing)
• Recurrent growths affecting your airway function
• Reduced quality of life due to voice problems

• The procedure is performed under general anaesthetic, meaning you will be asleep and feel no pain.
• A laryngoscope is inserted into your throat to allow the surgeon to view your vocal cords.
• The papillomas are carefully removed using the chosen technique.
• The procedure usually takes 30 to 60 minutes.
• You will be monitored in a recovery area before going home, usually on the same day.

• Improved voice quality
• Relief from breathing difficulties
• Slower regrowth of papillomas
• Prevention of airway obstruction

As with any procedure, there are some risks involved, including:

• Temporary or permanent hoarseness
• Mild sore throat or discomfort after the procedure
• Temporary breathing difficulties due to swelling
• Rare risk of infection or bleeding
• Potential scarring of the vocal cords, which may affect voice quality
• Recurrence of papillomas, requiring further treatment

• Voice rest may be recommended for a few days to allow healing.
• Avoid whispering, shouting, or excessive throat clearing.
• Drink plenty of fluids and eat soft foods if your throat feels sore.
• Mild discomfort is normal, but severe pain or breathing difficulties should be reported to your doctor immediately.
• A follow-up appointment will be scheduled to monitor your recovery.

Contact your doctor if you experience:

• Difficulty breathing or worsening stridor
• Persistent severe pain or bleeding
• Fever or signs of infection (redness, warmth, or pus at the surgical site)
• Worsening hoarseness or loss of voice

Q: Will the papillomas come back?
A: Unfortunately, RRP is a recurrent condition, and papillomas may regrow over time. Regular follow-ups and treatment sessions may be needed.

Q: When can I return to work or normal activities?
A: Most patients can resume daily activities within a few days, depending on voice usage and recovery. Avoid strenuous activities for at least a week.

Q: Can this procedure cure RRP?
A: There is no complete cure for RRP, but this procedure helps manage symptoms and maintain better vocal function.

Type 1 thyroplasty is a surgical procedure performed to reposition a weak or paralysed vocal cord to improve voice quality and strength. It is used to treat conditions such as:

• Unilateral vocal cord paralysis (one vocal cord not moving properly)
• Vocal cord atrophy (age-related voice weakness)
• Certain neurological conditions affecting the voice

The goal of the procedure is to enhance voice strength, reduce breathiness, and improve swallowing function.

Your doctor may recommend this surgery if you experience:

• A weak, breathy, or hoarse voice
• Difficulty being heard in conversations
• Frequent coughing or choking while eating or drinking
• Poor voice projection that affects communication

• The operation is usually performed under local anaesthesia with sedation, allowing the surgeon to adjust the vocal cord position while monitoring your voice. 
• Occasionally, this operation may also be performed under general anaesthetic at the patient's request. 
• A small incision is made in the neck over the voice box (larynx).
• A small implant (such as silicone, Gore-Tex, or other materials) is inserted into the larynx to push the weak vocal cord towards the middle, improving voice function.
• The position of the implant is adjusted based on real-time voice testing.
• The procedure usually takes 90 to 120 minutes, and most patients go home the same day.

• Stronger, clearer voice with better projection
• Reduced vocal fatigue
• Less breathiness when speaking
• Improved swallowing function

As with any surgery, there are some risks involved, including:

• Swelling and bruising around the incision site
• Temporary hoarseness or discomfort
• Infection (rare)
• Over- or under-correction, which may require revision surgery
• In rare cases, difficulty breathing due to swelling

• You may have mild throat discomfort or swelling for a few days.
• Avoid heavy lifting or strenuous activity for at least one week.
• Voice rest is not required, but avoid excessive shouting or straining your voice.
• Most patients notice voice improvement immediately, with further enhancements over the following weeks.
• A follow-up appointment will be scheduled to assess healing and voice outcomes.

Contact your doctor if you experience:

• Difficulty breathing or severe swelling
• Persistent pain or signs of infection (fever, redness, pus)
• Worsening hoarseness or loss of voice

Q: Will my voice be completely normal after surgery?
A: While the procedure significantly improves voice quality, it may not restore it to a completely normal level. Voice therapy may further enhance results.

Q: How long does the implant last?
A: The implant is designed to be permanent, but adjustments or revisions may be needed in some cases.

Q: When can I return to work?
A: Most patients can return to light work within a few days and normal activities in one to two weeks, depending on their job and voice demands.

An anterior laryngeal web is a thin band of tissue between the vocal cords, usually located at the front (anterior) part of the voice box (larynx). It may be present from birth (congenital) or develop later due to injury, infection, or previous surgery.

This web can affect the voice (causing it to sound weak, hoarse, or high-pitched), and in some cases may cause breathing difficulties.

This is a surgical procedure done under general anaesthetic to:

• Closely examine your voice box using a microscope
• Divide (cut through) the web using delicate instruments or a laser
• Restore normal vocal cord movement and improve voice or breathing

You may be recommended this surgery if:

• Your voice is affected (e.g. hoarseness, limited pitch range, vocal fatigue)
• You are experiencing breathing difficulties or noisy breathing (stridor)
• The web is affecting vocal cord movement or closing

The procedure aims to improve the function of the vocal cords by carefully separating the web and preventing it from growing back.

• You will be given a general anaesthetic (you will be asleep).
• A rigid tube (laryngoscope) is gently inserted through your mouth to access your voice box — no external cuts are made.
• A microscope is used to provide a detailed view.
• The web is divided using fine instruments or a laser.
• In some cases, a small stent (spacer) may be placed temporarily to help keep the vocal cords apart during healing and prevent the web from reforming.

The operation typically takes around 60 minutes.

Common (usually temporary):

• Sore throat or mild discomfort for a few days
• Hoarseness or voice changes while healing
• Swelling or mild bruising in the throat

Less common:

• Bleeding
• Infection
• Reformation of the web, which may require repeat surgery
• Scarring, which could affect the voice
• Injury to teeth, gums, or lips from the instruments (rare)

If a stent is used, there may be additional monitoring and a second procedure to remove it.

• Most patients go home the same day or after an overnight stay, depending on the case.
• You may need to follow a period of voice rest (usually a few days).
• Your surgeon will advise if any dietary restrictions or care around a stent are needed.
• Voice therapy may be recommended after surgery to support healing and voice recovery.
• Full recovery may take several weeks, especially if a stent is used.

Contact your doctor or hospital if you experience:

• Breathing difficulty
• Ongoing or heavy bleeding
• High fever or signs of infection
• Severe or worsening pain

• Monitor healing
• Remove the stent (if used) in a further operation
• Discuss voice recovery and further treatment or therapy if needed

• An anterior laryngeal web is a band of tissue affecting your voice or breathing.
• Surgery is done under general anaesthetic to divide the web and improve function.
• Recovery includes voice rest, possible voice therapy, and follow-up care.
• Risks are low, but reformation of the web can occasionally occur.