Phonosurgery Your Care at Home after Thyroplasty
There are many treatments for voice disorders.
Phonosurgery: any surgery done to improve your voice
Thyroplasty: a type of phonosurgery; it can restore the quality of your voice by changing the shape of the thyroid cartilage
Other treatment options
- Injections
- Microsurgery
- Laser surgery
- Laryngeal framework surgery
Even though these options are thought of as "minor surgery," there are always benefits and risks. The outcome of surgery doesn't rely on the surgeon alone. The patient, family, and speech pathologist all play a role in helping to achieve the best possible result. There are some general things you should know about phonosurgery and how to care for your voice.
About Phonosurgery
The goal of treatment is to improve your voice. You likely won't notice the improvement right after surgery. Sometimes, it takes weeks or months for the best voice to occur. Because the voice box is fragile, there is always a chance that function will not improve. Your voice could get worse. There may be several reasons for this.
Reasons for no improvement
- " Operative technical problem
- unpredictable scarring
- complications
- poor preparation
- improper use of your voice after surgery
- failure to control reflux
- cold or respiratory infection at the same time
- active allergies
- smoking
In most cases, you can expect positive results. Bleeding, shortness of breath, choking, allergic reactions and problems with anesthesia are rare.
Patients treated with botulinum toxin injections will often have a period of breathlessness during speech. They may choke on liquids swallowed too quickly during the first week. This is a normal side effect. Others may find that the voice is worse during the first week due to swelling and early healing.
Resting your voice after surgery
Asking you to not talk at all is too hard for you to do. For most patients, we suggest using your voice very little for the first 24 hours. During this 24-hour period, you should avoid strenuous activity, talk only when needed, and try to humidify the air you breathe. During the first week, use your voice very little, but always try for a natural voice rather than a whisper. Do not try to speak in a loud voice. Avoid talking over background noise such as in a moving car. It will not help to whisper. Though the vocal cords do not vibrate during a soft whisper, the effort required to make a whisper loud enough to be heard may damage the vocal cords. Loud whispering is not normal use of the voice. This will make it harder for you to gain a natural voice.
Getting good results
Your surgery is more likely to be a success if you are healthy. Phonosurgery is elective and should not be done when you have an active upper respiratory infection or allergic flare-up. During this time, the vocal cords are congested. Fragile blood vessels are more likely to bleed. Healing after the surgery may be harder. Allergic swelling may complicate surgery and produce coughing. The allergy may also cause hoarseness after surgery.
- Eat healthy foods and drink plenty of liquids. This will help make anesthesia safer and lead to good results.
- The vocal cords are very sensitive to drying. Dry vocal cords can mean they will vibrate improperly. Drink enough liquids to make nearly clear urine.
- Avoid drinks with caffeine and medicines which will cause you to lose fluids. Most decongestants will cause drying of the vocal cords. Avoid them for the first few weeks.
- If you suffer from heartburn, dyspepsia, or other gastric reflux symptoms, talk with your doctor about how to treat this before and after surgery. Stomach acids can damage the vocal cords, especially during healing.
Caring for your voice
Your goals should be based on getting the best voice you can, rather than trying to achieve your notion of an ideal voice. A vocal health program can help you gain the best result. The speech pathologist will help you with vocal health measures. The goal of vocal health is to improve the way the voice box works and avoid those things that irritate the voice box.
For Best Results
| Do's | Don'ts |
| General body conditioning with regular exercise | Avoid high stress and strenuous activities |
| Activities that improve heart health, breathing and relaxation | Avoid weight lifting (can cause vocal cord problems because it demands a sustained, forceful contact of the vocal folds) |
| Humidify air you breathe | Avoid smoke and chemical irritants |
| Use proper posture | Avoid things you know cause you to have an allergic reaction |
| Work toward stress reduction and muscle relaxation |
Avoid noisy places (talking over noise can cause vocal fatigue and may damage the vocal folds
Avoid noisy places (talking over noise can cause vocal fatigue and may damage the vocal folds
Avoid excessive dryness and temperature extremes
Eliminate excessive talking, shouting and using extremes in pitch
Avoid whispering, dry coughing, and frequent throat clearing
Limit caffeine and avoid food near bedtime |
What to expect after surgery
You can expect that your throat will be sore. Be sure to ask for pain medicine when needed. You will have a dressing in place over your stitches. You may also have a small drainage tube under the dressing. You may see a small amount of blood-tinged drainage.
You will start with liquids after surgery. You can change to a soft diet when you are ready. Later, you can return to your normal diet.
Your dressing will be removed the day after surgery. Your stitches will be cleaned by the nurse before you go home. Once home you can clean those stitches once a day with a mild soap and water. Stitches will be removed 5-7 days after surgery.
What to do
- Avoid extremes of loudness and pitch. Avoid throat clearing, gargling and whispering.
- Drink plenty of fluids even if you are not able to eat much solid food.
- Check your incision daily for any signs of infection. Watch for redness, swelling, tenderness, warmth at the site, or any pus-like drainage.
- You may shower and get the incision wet the day after your drainage tube is removed. Do not soak your incision with water.
- For the next 3 days, raise your head at least 30 when you lie down. Do not lie flat in bed. Use at least 2 pillows to raise your head 30 .
- Restrict your activities for at least one week or for as long as your doctor advises. No jogging, aerobics, swimming, strenuous activity, or lifting more than 25 pounds.
When to call your doctor
- Pain that is not relieved by medicine
- Temperature greater than 100.5° F for two readings taken 4 hours apart
- Signs of infection
- Other questions or concerns
You will be scheduled to return to the ENT Clinic after surgery. Your doctor will check the surgical site and ask how you are doing. This is a good time to get your questions answered.
Phone numbers
If you have any questions or problems once you are home, please call:
ENT Clinic, Monday to Friday, from 8:00 AM to 5:00 PM at (608) 263-6190.
After hours, weekends or holidays, the clinic number will give you the paging operator. Ask for the ENT doctor on call. Leave your name and phone number with the area code. The doctor will call you back.
If you live out of the area, call 1-800-323-8942.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 03/30/2011
Copyright © 03/30/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5315
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