At a glance
- Purpose
- To remove benign vocal cord lesions that affect the voice.
- Technique
- Microlaryngeal surgery (phonosurgery) under a microscope, with fine instruments or laser.
- Anaesthesia
- General, through the mouth, with no external incisions.
- Hospital stay
- Day surgery.
- Recovery
- Voice rest for one week and, in some cases, voice therapy afterwards.
Why the voice changes
The voice is produced when air makes the vocal cords vibrate. For a clear sound, their edges must be smooth and flexible. When a lesion appears, however small, vibration is disturbed and the voice becomes hoarse, rough, tired or is lost altogether (dysphonia or aphonia).
Most common lesions
- Nodules: thickening on both cords from overuse or misuse of the voice. Common in teachers, singers, salespeople and children.
- Polyps: usually on one cord, sometimes after vocal strain or a small bleed.
- Reinke’s oedema: swelling of the cords closely linked to smoking, which lowers the voice.
- Cysts and other benign lesions.
Diagnosis
- Video laryngoscopy or fibre-optic endoscopy of the nose, throat and larynx, done at the clinic in a few minutes.
- Stroboscopy: a special light shows the vibration of the cords in slow motion and helps tell lesions apart. It is essential to decide whether to operate.
- Assessment of how you use your voice and, where relevant, reflux, allergy or smoking.
Voice therapy first
Many nodules and some small lesions improve with speech therapy and by correcting what causes them. Surgery is considered when the lesion does not respond, or when, like most polyps, it will not go away on its own.
Phonosurgery
It is done under general anaesthetic, through the mouth, using a microscope and very fine instruments or a laser. The lesion is removed with maximum precision, preserving the surface layer of the vocal cord on which voice quality depends. There are no external incisions and patients normally go home the same day.
Recovery
- Voice rest for one week.
- Gradual return to using your voice and, in some cases, voice therapy.
- Check-up with stroboscopy to confirm healing.
- Most patients recover a normal voice within weeks; professional voice users follow a specific return-to-work plan.
Risks
Mild throat discomfort, minor injury to teeth or mouth from the instruments, scarring of the vocal cord with voice changes, or recurrence if the causes persist. We will explain those that apply in your case before surgery.
Frequently asked questions
Do nodules always need surgery?
No. Most nodules improve or disappear with voice therapy from a speech therapist. Surgery is kept for those that do not respond. Polyps, on the other hand, usually need surgery.
How long will I have to stop talking?
Voice rest is advised for one week, followed by a gradual return; in some cases, with voice therapy. We will give you specific advice depending on the lesion and how you use your voice.
I am a singer or use my voice a lot at work. Is surgery risky?
Phonosurgery is designed precisely to preserve as much as possible of the vocal cord's surface layer, on which voice quality depends. We plan surgery and rehabilitation with particular care for professional voice users.
When should I see someone about hoarseness?
If it lasts more than two or three weeks without a clear cause, especially if you smoke. Most causes are benign, but the vocal cords need to be seen to rule out other lesions.
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Before surgery you receive the informed consent document of the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC), which explains the technique, its alternatives and its risks.
Guidance written by the team of Dr. Carlos Magriñá, an ENT surgeon with more than 35 years of experience in Barcelona. Every case needs an individual medical assessment.