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The vocal cords, also known as the vocal folds, are two bands of smooth tissue that are covered with mucous membranes located side-by-side in the voice box (larynx). The vocal cords guard the entrance to the windpipe. They vibrate and air passes through the cords from the lungs to produce the sound of your voice.
When the mucosa of the vocal cords is damaged or strained, doctors may recommend a surgical procedure called decortication of vocal cords as a treatment option. In the decortication of vocal cords, the damaged mucosa of the vocal cords is removed. Your doctor may recommend this procedure if:
There’s a growth in your vocal cords
There’s an infection in your vocal cords
You experience symptoms of vocal cord dysfunction, including raw feeling at the back of the throat, loss of vocal range, difficulty breathing, hoarseness, and a constant need to clear the throat.
Decortication of vocal cords is most often used to treat Reinke’s Edema. This is a condition in which the vocal cords swell and/or develop polyps, affecting voice quality.
Your doctor will perform preliminary tests, such as blood tests and electrocardiograms to ensure that you are the ideal candidate for the procedure.
During the procedure, you will be given general anesthesia. Your doctor usually uses microlaryngoscopy to perform decortication of vocal cords, which involves inserting a laryngoscope into your mouth and down the throat. A laryngoscope is a throat scope that helps your doctor to view below the back of your throat where your larynx that contains your vocal cord is located. Guided by the laryngoscope, your doctor will start to remove layers of the vocal cords using a laser. Depending on your condition, your doctor may also remove tumors, excess growth (such as papillomas), or swelling from the vocal cords using the laser or powered instruments with rotating blades. Your doctor will try to restore your original voice as much as possible.
You should be able to leave the hospital on the day of surgery. However, you should not leave Thailand immediately after you are discharged from the hospital. It is recommended that you stay for about 5 to 7 days for follow-up checkups. During the follow-up checkups, your doctor will check your condition and see if everything is okay, you will be allowed to leave for home.
You should not speak or use your voice for three to five days to allow your vocal cords to heal. If your job does not involve using your voice and physical activity, you should be able to go back to work within a week or two. It may take around 6 to 8 weeks for your vocal cords to fully recover, so make sure to treat your voice with care during this time. Your doctor will give you a recovery timeline, including the exact time you can go back to work, exercise, and use your voice normally.
Your doctor will give you complete aftercare instructions. The instructions may include:
Make sure to always have ready access to pen and paper to communicate during your recovery period since complete voice rest is an important part of a full recovery.
Have someone help you out for the initial recovery time.
After complete voice rest, you may slowly begin to use your voice again. Note that you should speak no louder than a soft conversational volume and speak less than usual.
Do not clear your throat, cough unnecessarily, shout, whisper, sing, laugh loudly, or raise your voice.
Attend a vocal cord rehabilitation program to restore your vocal cord function.
Drink plenty of fluids, but avoid caffeinated and alcoholic drinks as both can dry out your vocal folds.
Do not smoke and avoid smoky atmospheres.
Do not answer the telephone. Ask people to email or text you instead.
The decortication of vocal cords is considered a safe procedure with high success rates. It is effective to treat problems in your vocal cords. While it is very safe, you should be aware of the potential risks, including nausea, vomiting, drowsiness, sore throat, permanent injury to the vocal cord, damage to nearby structures, significant bleeding, lung problems, and swelling of the airway.
The alternative to decortication of vocal cords depends on your specific condition. For instance, if you have vocal cord dysfunction, you may consider speech therapy with specific voice and breathing exercises as the alternative. For Reinke’s edema, your doctor may recommend lifestyle changes (stop smoking and avoiding activities that can cause vocal distress) and controlling gastric reflux using antacids and/or Proton Pump Inhibitors.
Before decortication of vocal cords, you may have problems in your vocal cords, such as vocal cords dysfunction or Reinke’s edema, or there may be an infection or excess growth in your vocal cords. After the procedure, all of these problems should be resolved and symptoms should be relieved. In most cases, you should be able to use your voice normally again.
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