Laryngology

Laryngology is a branch of medicine that focuses on both larynx problems and its general health. Due of the complexity of the larynx, laryngologists need to complete additional, specialized medical training that focuses particularly on the pharynx, the section of the larynx and neck that reaches from the base of the skull to the esophagus. A full range of voice and swallowing diseases, such as vocal nodules, spasmodic dysphonia, vocal cord paralysis, respiratory papilloma, and more, are treated by laryngologists. (1)

Definition and Overview

A laryngologist is a medical professional who specializes in the diagnosis and treatment of conditions affecting the larynx, pharynx, and other neck-related organs. For healthy breathing, swallowing, and sound production, the larynx is essential. As a result, voice, swallowing, and breathing issues are brought on by diseases of the larynx and its supporting tissues. Specialists in treating these diseases are laryngologists. Laryngology is a branch of Otolaryngology - Head and Neck Surgery, a field of medicine concentrating on the diagnosis and treatment of ear, nose, and throat conditions. (2)

Procedures

Laryngology is a range of medical procedures performed on the larynx, sometimes known as the voice box. Laryngology is a discipline of otolaryngology (ear, nose, and throat medicine) that focuses on the diagnosis and treatment of laryngeal issues. The following are some frequent laryngology procedures:

• Laryngoscopy

The larynx, or voice box, is examined by a laryngoscopy procedure. The larynx is located deep within the throat, making it more difficult to inspect with a flashlight than the mouth and nose. A light coupled to a mirror is used during laryngoscopy, or a specialized tool called a laryngoscope is used to observe the larynx.

• Laser surgery of the vocal cord

Special lasers are used during this minimally invasive procedure to treat benign lesions, cancer of the vocal cord, and tumors that affect the vocal cord. General anesthesia is used during laser surgery, which typically takes 60 to 90 minutes to complete in an operating room. Most patients are generally allowed to leave the hospital on the same day.

• Laryngeal framework surgery

By altering the cartilage where the muscles join to the vocal cords, this procedure can increase the tension or assist the vocal cords closing more effectively. The vocal folds vibrate as a result, producing greater sound for speaking and singing. In order to cure individuals with vocal cord paralysis or laryngeal stenosis and restore their larynx to its former shape, laryngeal framework surgery is performed.

Additionally, it can be used to treat patients who have undergone laryngectomy surgery, cancer surgery, or surgery that damaged their nerves. In order to speak with the patient, acquire his or her feedback, and make adjustments to improve the voice, the procedure is carried out under local anesthetic

• Vocal cord injections

Conditions like vocal cord paralysis or muscle weakness are temporarily treated with injections of collagen and other gel fillers. This procedure enhances swallowing or voice function. Sometimes, medication is injected. Local anesthetic is commonly used during injections in the doctor's office. The vocal cord is directly injected with the substance by the doctor through the skin of the neck.

• Phonomicrosurgery

Phonomicrosurgery is the procedure for creating vocal cords under the microscope with or without a laser. It is carried out in a variety of laryngeal (voice box) conditions, including vocal cord lesions, biopsy, injection, and scarring that narrows the airway. (3,4)

Candidates

If there are breathing or swallowing difficulties involving the larynx, the primary care provider may refer the patient to a laryngologist. If a patient experiences symptoms like hoarseness that do not go away, he/she can also consult a laryngologist. The vocal cords' natural functioning may change as a result of repeated voice abuse and usage. Without treatment, these alterations could harm patients permanently. Patients should visit an otolaryngologist or laryngologist if the hoarseness persists for longer than two to four weeks without an identified reason. 

If a patient is diagnosed with the following laryngeal disorders, a laryngologist examines the patient’s medical history and determines the specific treatment procedure.

• Infectious Laryngitis
• Laryngeal Cancer
• Vocal Fold Leukoplakia and Dysplasia
• Reflux Laryngitis
• Vocal Cord Swelling / Reinke’s Edema
• Laryngeal Papillomatosis
• Spasmodic Dysphonia
• Vocal Fold Granuloma and Scar
• Vocal Fold Nodules, Polyps, Cysts
• Voice Dysfunction in Neurological Disorders
• Pediatric Voice Disorders
• Presbylaryngis (Aging Voice)
• Cricopharyngeal dysfunction
• Zenker’s Diverticulum
• Esophageal strictures and webs
• Laryngotracheal stenosis
• Muscular Tension Dysphonia (5)

Risk and Side Effects

Treatments for laryngeal disorders are generally considered highly safe, and the risks and side effects are procedure dependent. Frame surgery such as thyroplasty and implants can have complications associated with surgery and general anesthesia, such as

• bleeding
• infections
• damage to the spine
• spinal fluid leakage
• voice changes
• failure to reduce pain
• reactions to anesthesia
• hoarseness (6)

Post-Procedure and Follow-up

A comprehensive medical history and physical examination are part of an evaluation to look for issues like nerve entrapment or thyroid gland problems. The patient's larynx and throat are also examined during the larynx exam. The patient's symptoms will determine whether more tests are required. A functional endoscopic swallowing evaluation (FEES), a reflux test, an x-ray, or other endoscopic tests may be among these. After the treatments are applied, the doctor and other healthcare professionals follow the patient closely. The mouth and throat may be numb for several hours. The doctor decides the discharge time according to the patient's recovery, pain, and general health status.

Recovery

Recovery from treatment often takes 1 to 2 weeks. The timetable, however, is dependent on a number of variables, such as the complexity of the procedure and the body's ability to recuperate. Some individuals require more time for recovery. During the recovery process, instructions and necessary training can be taken by healthcare providers in terms of breathing, speaking, and swallowing.

Results

In most cases, laryngology treatments are successful. The doctor arranges regular follow-ups to monitor the progression of the disease. This is essential for the best results.

The medical staff works with the patient to teach them new breathing, speaking, and swallowing techniques after treatments. This may include working with a speech-language pathologist to help patients communicate effectively.

A thorough list of post-operative instructions and guidelines from the healthcare provider should be meticulously followed throughout the healing period for best results.