Name of the Procedure:

Laryngoscopy, Direct, Operative, with Arytenoidectomy

• Common name(s): Direct Laryngoscopy with Arytenoid Removal
• Medical term: Direct Operative Laryngoscopy with Arytenoidectomy

Summary

A direct laryngoscopy with arytenoidectomy is a surgical procedure where a surgeon uses a special instrument called a laryngoscope to view the voice box (larynx) and remove one of the arytenoid cartilages. This procedure helps address issues related to voice, breathing, or swallowing due to abnormalities or damage in the arytenoid cartilage.

Purpose

• Medical Condition or Problem: Treatment of vocal cord paralysis, laryngeal stenosis (narrowing), tumors, or other structural issues affecting the voice box.
• Goals/Outcomes: To improve airway function, restore vocal quality, relieve breathing difficulties, and enhance swallowing.

Indications

• Symptoms such as persistent hoarseness, difficulty breathing, or swallowing difficulties.
• Conditions like vocal cord paralysis, laryngeal stenosis, and tumors in the larynx.
• Patients who do not respond to conservative treatments or have significant airway obstruction.

Preparation

• Pre-procedure Instructions: Patients may be asked to fast (no eating or drinking) for several hours before the procedure.
• Medications: Adjustments might be required, particularly for blood thinners.
• Diagnostic Tests: Preoperative assessments, including imaging (like a CT scan) and vocal cord examination.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Positioning: The patient is positioned in a way that allows easy access to the larynx.
3. Laryngoscope Insertion: A laryngoscope is inserted through the mouth to visualize the larynx directly.
4. Arytenoid Excision: The surgeon identifies and removes the arytenoid cartilage using specialized surgical instruments.
5. Closing: The area is inspected, and any necessary sutures or adjustments are made.

Duration

• The procedure typically takes about 1 to 2 hours.

Setting

• Usually performed in a hospital's operating room or a surgical center.

Personnel

• The surgical team typically includes an ENT (Ear, Nose, and Throat) surgeon, an anesthesiologist, and surgical nurses.

Risks and Complications

• Common Risks: Soreness, temporary hoarseness, or mild bleeding.
• Rare Complications: Infection, significant bleeding, airway obstruction, or damage to surrounding structures.

Benefits

• Expected Benefits: Improved airway function, regained vocal quality, and easier swallowing.
• Timeline: Benefits are generally noticeable within a few weeks as healing progresses.

Recovery

• Patients may need to stay in the hospital for a few hours or overnight for observation.
• Post-Procedure Care: Follow-up appointments, voice rest, and possibly speech therapy.
• Recovery Time: Usually a few weeks with some restrictions on voice use and physical activity.

Alternatives

• Other Treatments: Voice therapy, less invasive endoscopic procedures, or different types of surgery, depending on the specific condition.
• Pros and Cons: Alternatives might be less invasive but also less definitive in addressing the underlying problem.

Patient Experience

• During the procedure, the patient will be under general anesthesia and not feel anything.
• After the Procedure: Sore throat, mild to moderate discomfort, managed with pain medications.
• Comfort Measures: Voice rest, hydration, and follow-up care to manage any discomfort and ensure proper healing.