Do you sometimes feel that your voice is hoarse, weak, or as if you are choking when you speak? Do you get a hard time swallowing food? Do you often have a sore throat? These can be symptoms of a common cold, but if they persist, it could be a problem with your vocal cords. So today, let's talk about a surgery called 'thyroplasty' that can help with this condition and restore your voice.
First, let's see, what is vocal cord paralysis?
In simple terms, there is a part of our throat called the larynx. We also call it our "voice box." Inside this is two thin, fleshy structures called vocal cords. When we speak or cough, air from our lungs passes through these two vocal cords. These two cords then vibrate, creating our voice.
Imagine, what happens if one of these two vocal cords does not work properly or if it becomes inactive? That is when we call this vocal cord paralysis . At this time, a gap is created between the inactive vocal cord and the functioning vocal cord. This causes the voice to become weak and hoarse. Most of the time, only one vocal cord is inactive. Inability of both vocal cords is a very rare but serious condition that requires immediate medical attention.
What are the common symptoms of this condition?
If you have vocal cord paralysis, you may experience one or more of the following symptoms.
| Symptom | Description |
|---|---|
| Hoarseness | The voice becomes unclear, weak, and windy. |
| Difficulty swallowing (Dysphagia) | Choking and coughing when swallowing food or drink. |
| Frequent throat clearing | Trying to clear your throat because you constantly feel like something is stuck in your throat. |
| Difficulty breathing | Shortness of breath when talking or doing minor activities. |
| Chronic cough | A cough that lasts for a long time without any specific cause. |
Who needs Thyroplasty surgery?
Not everyone with these symptoms will need surgery. Some people's symptoms are mild and they can live a normal life without any problems. However, if your voice problem is making it difficult to perform at work, have difficulty maintaining social relationships, or if you have life-threatening conditions such as choking , your doctor may recommend this surgery.
Simply put, thyroplasty is a surgical procedure that uses a small implant to move the dysfunctional vocal cord toward the healthy vocal cord, reducing the gap between the two.
Things that can cause vocal cord paralysis
There are many reasons for this condition, and sometimes no clear cause can be found.
| Possible cause | Examples |
|---|---|
| Autoimmune diseases | Diseases such as Myasthenia Gravis. |
| Cancer | Lung cancer, thyroid cancer. |
| Treatment for cancer | Radiation therapy to the head, neck, or chest area. |
| Diseases of the nervous system | Parkinson's disease, stroke. |
| Neck or chest surgery | Heart surgery, thyroidectomy. |
| Use of a breathing tube during surgery | Intubation or Mechanical Ventilation. |
| Infections | Respiratory system infections such as flu and colds. |
How is the surgery done?
This surgery is performed by an ear, nose, and throat specialist (ENT surgeon), a doctor who has special expertise in the larynx and vocal cords.
Before surgery
You should follow your doctor's instructions exactly. For example:
- Avoid eating and drinking for a few hours before surgery.
- If you smoke, stop.
- You may need to stop taking certain medications and vitamins. Your doctor will explain all of this to you.
During surgery
Thyroplasty is performed in an operating room. In most cases, you are not fully anesthetized. Only the neck area is numbed and the surgery is performed while you are awake. This is because your voice needs to be checked during the surgery and the implant needs to be placed correctly.
1. First, the doctor will make a small incision in your neck.
2. Next, a small window is made through the larynx (voice box) where the paralyzed vocal cord is located.
3. Then, after asking you to speak, they listen to your voice and insert a specially designed implant that fits it. This pushes the inactive vocal cord into the middle, making it easier for it to collide with the other vocal cords.
4. Once the voice is at its best, the incision is closed with dissolvable stitches.
What happens after surgery? What should I do to recover quickly?
You may be able to go home the same day after surgery, or you may need to stay in the hospital overnight. The surgery is very successful, and many people see a clear improvement in their voice.
As with any surgery, there is a small risk of infection and bleeding. A small scar will be left on the neck. There may be temporary neck pain, changes in voice, and difficulty swallowing for a few days after the surgery.
But remember, these side effects are rarely permanent. They usually go away after a few days.
Follow these steps to recover quickly:
- Give your voice a rest: Give your voice a rest for a few days after surgery. This means avoiding shouting, talking loudly, or talking for long periods of time. You don't need to be completely silent. You should be able to speak normally in about a week.
- Fluids and soft foods: If you have a sore throat, drink plenty of water. Eat soft foods like porridge and yogurt in the early days.
- Do not let the incision get wet: Avoid bathing for three days after surgery. Keep the incision and the bandage dry.
- Take your medication exactly as prescribed: Take the antibiotics, steroids, and painkillers exactly as prescribed by your doctor.
- Avoid lifting weights: Do not lift anything heavier than 7 kg (15 lbs) for two weeks. Avoid strenuous exercise like running. Walking is fine.
- Voice Therapy: If your doctor recommends it, see a voice therapist for advice.
When should you call the doctor immediately?
If you experience any of the following symptoms after surgery, call your doctor immediately or go to a hospital.
| Feature to pay attention to | Description |
|---|---|
| Difficulty breathing | This is an emergency. Go to the nearest hospital Emergency Department (ETU) immediately. |
| Severe pain | Severe pain that cannot be controlled even with medication. |
| Signs of infection | Fever, yellow pus-like fluid draining from the incision. |
| Swelling or bleeding | Excessive swelling (edema) or bleeding at the incision site. |
Take-Home Message
- Thyroplasty is a successful surgical procedure to restore function to a dysfunctional or weakened vocal cord.
- This will make a clear improvement in your voice and also solve problems such as swallowing difficulties.
- This surgery is performed by an ear, nose, and throat specialist (ENT surgeon).
- If you have a long-term voice problem, don't be ashamed or afraid of it, but see a doctor and seek advice.
- It is very important to follow the doctor's instructions exactly for a speedy recovery after surgery.
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