Phonosurgery – Precision Work for the Voice

Phonosurgery is like a finely tuned orchestra that uses precise instruments to restore the harmony of the voice. Prof. Dr. Bigenzahn uses examples to describe how this precision work is carried out at the WPK.

Thanks to the development of modern surgical techniques, devices and instruments, such as the surgical microscope, surgical laser, tubeless anesthesia (so-called jet anesthesia), voice-improving and voice-preserving surgical procedures on the vocal apparatus can be performed with the highest precision at the Wiener Privatklinik.

The aim of voice-improving microsurgery is to remove benign, vibration-impairing changes to the vocal folds, e.g. “phonation thickening”, vocal fold nodules, vocal fold polyps and vocal fold cysts. The operation is performed directly under microscopic vision using small, fine instruments (e.g. forceps, scissors) or with the help of a surgical laser via a special tube through the mouth.

However, phonosurgical procedures should only be performed after comprehensive preoperative diagnostics. The indication for voice-improving surgery is based on the patient’s wishes and needs, the morphological and functional findings, and after all conservative treatment options have been exhausted, i.e. medication, inhalation and speech therapy and voice therapy (possibly supplemented by psychotherapy).

Knowledge of vocal hygiene measures is an important prerequisite for maintaining a healthy voice. The most important of these include:

• Correct breathing with an upright posture
• Regular vocal rest and breaks
• A balanced rhythm of life and sleep
• Little nicotine and alcohol
• Protecting the voice in the event of respiratory tract infections
• Fluid intake to avoid drying out of the mucous membranes
• No unnecessary stress

The main symptom of any voice disorder is hoarseness If this persists for more than two to three weeks, a diagnostic examination by an ENT specialist or phoniatrist is essential.

The examination is simple and hardly stressful for the patient. The larynx is examined indirectly using a mirror or directly using a rigid or flexible endoscope, usually with video documentation.

From the age of 50, regular ENT or phoniatric check-ups should be carried out so that malignant laryngeal disease can be detected in good time.

Phonosurgery – functional surgery to improve the ability to communicate verbally

“Phonosurgery is not an aesthetic measure, but functional surgery to improve the patient’s ability to communicate verbally.” In the treatment of unilateral and bilateral vocal fold paralysis, e.g. after thyroid, heart and lung operations, new surgical techniques have brought great progress in the preservation and restoration of the voice. Loss of elasticity in the vocal folds, which occurs in old age in conjunction with voice weakness, is also functionally improved by interventions on the laryngeal skeleton, but also by injecting substances into the vocal fold body.

In the case of bilateral vocal fold paralysis, laser surgery to widen the glottis (vocal process resection) has proven successful. In many cases, this saves the patient from having to undergo a tracheotomy. We are happy to advise our patients at the Vienna Private Clinic in detail about these procedures.

At a time when the voice and communication are becoming increasingly important, phonosurgery not only offers us the opportunity to treat voice disorders, but also to improve and maintain essential communication skills!