Phonosurgery

Phonosurgery is a specialized branch of laryngeal surgery aimed at improving, restoring, or modifying the voice by addressing structural or functional disorders of the vocal cords (vocal folds). It is performed by ENT specialists or laryngologists and is particularly important for professional voice users such as singers, teachers, and public speakers.

Causes

Voice problems requiring phonosurgery can arise from various conditions. These include benign lesions like vocal cord nodules, polyps, or cysts; vocal cord paralysis or paresis; scarring; sulcus vocalis; and early-stage laryngeal cancers. Overuse or misuse of the voice, smoking, acid reflux (laryngopharyngeal reflux), and trauma to the larynx are common contributing factors. Some conditions may also result from aging (presbylaryngis) or neurological disorders.

Symptoms

Patients may experience persistent hoarseness, a breathy or weak voice, vocal fatigue, changes in pitch, difficulty projecting the voice, or pain during speaking. In severe cases, there may be loss of voice or difficulty breathing if airway obstruction occurs. These symptoms often interfere with professional and social communication, affecting quality of life.

Treatment

Phonosurgery is tailored to the patient’s condition and voice needs. Common procedures include microlaryngeal surgery to remove lesions, medialization thyroplasty to improve vocal cord closure, injection laryngoplasty for vocal cord augmentation, and scar or sulcus release. Surgery is often combined with pre- and post-operative voice therapy to optimize outcomes. Minimally invasive endoscopic techniques help preserve delicate vocal cord tissues and ensure quicker recovery. With proper surgical expertise and rehabilitation, most patients achieve significant improvement in voice quality and function.