Name of the Procedure:

Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis

Summary

A direct operative laryngoscopy is a medical procedure that involves using a specialized scope to view the inside of the larynx (voice box) and perform surgical actions such as removing tumors or stripping diseased tissue from the vocal cords or epiglottis.

Purpose

This procedure addresses conditions like tumors, polyps, or other abnormal growths in the larynx. The primary goal is to remove these abnormal tissues to restore normal function and prevent further complications, such as airway obstruction or malignancy.

Indications

• Presence of vocal cord tumors, benign or malignant
• Vocal cord nodules or polyps
• Chronic hoarseness or voice changes
• Difficulty breathing or swallowing due to laryngeal obstruction
• Diagnosed abnormalities in the larynx requiring surgical intervention

Preparation

• Patients are typically advised to fast for 6-8 hours before the procedure.
• Certain medications, particularly blood thinners, might need to be adjusted or stopped.
• Pre-procedure diagnostic tests may include imaging studies, laryngoscopy, or a biopsy.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Direct Laryngoscopy: A laryngoscope, a tube with a light and camera, is gently inserted through the mouth to access the larynx.
3. Excision/Stripping: Using specialized surgical instruments, the surgeon removes the tumor or strips diseased tissue from the vocal cords or epiglottis.
4. Monitoring: Continuous monitoring of vital signs throughout the procedure.

Duration

The procedure typically takes 30 minutes to an hour, depending on the complexity of the case.

Setting

This procedure is performed in a hospital operating room or a surgical center equipped for general anesthesia.

Personnel

• ENT (Ear, Nose, and Throat) Surgeon
• Anesthesiologist
• Surgical Nurse
• Operating Room Technician

Risks and Complications

• Infection
• Bleeding
• Damage to vocal cords leading to changes in voice quality
• Swelling or airway obstruction
• Adverse reactions to anesthesia

Benefits

• Removal of obstructive or malignant tissue
• Improvement in breathing and swallowing
• Restoration of normal voice function
• Prevention of cancer progression or recurrence

Recovery

• Post-procedure, the patient will be monitored in the recovery room until the effects of anesthesia wear off.
• Patients might experience a sore throat or mild discomfort, managed with pain relievers.
• Voice rest is typically recommended for a few days to weeks.
• Follow-up appointments are necessary to monitor healing and ensure no recurrence.

Alternatives

• Non-surgical options: Voice therapy, medications
• Less invasive procedures: Laser therapy
• Pros: Less risk of complications
• Cons: May not be as effective in completely removing abnormal tissues

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel or remember anything. Post-procedure, a sore throat and hoarseness are common, but pain management will be provided. Full recovery and return to normal activities usually occur after a few days, with voice recovery potentially taking longer.