The information below is intended for patients who consider oral treatment of the voice. The guidelines given here can vary from surgeon to surgeon, hospital to hospital and from region to region. These guidelines are intended to better understand the procedure.
During a direct laryngoscopy, the vocal chords are viewed with a microscope, sometimes in combination with an endoscope to properly visualise and remove injuries. The intervention is done with the help of a CO2 laser and micro-instruments. This procedure is done under general anesthesia and in day hospitalisation.
Medialisation is a surgical procedure to add mass to one or both vocal cords in order to achieve a better closure of the vocal cords during speaking. This procedure takes place under sedation (mild anesthesia without intubation) and one night hospitalisation is provided for this. The procedure is also called "thyroplasty Isshiki type I" after Dr.Isshiki who invented this intervention and performed it first.
Injection is the injection of material into the vocal cords to increase the mass and thus achieve a better closure of the vocal cords. This material concerns Hyaluronate (Healon or Iuvederm) or Hydroxie apatite (for example Rénuvoice). An injection can be done in the operating room under general anesthesia via day hospitalisation or on the consultation after local anesthesia.
Meer info: R.W. BASTIAN, K.G. DELSUPEHE. Indirect Larynx and Pharynx Surgery : A replacement for direct laryngoscopy. Laryngoscope 1996;106:1280-86
These interventions are mainly performed in transgender patients if insufficient increase in voice can be obtained after intensive speech therapy. There are various possible techniques for this, in which we prefer the Wendler glottoplasty technique because it is the least invasive technique. Here, the vibrating part of the vocal cords is shortened by forming a web at the front of the voice gap, which increases the pitch. This procedure is done under general anesthesia via day hospitalisation.
More info: Pitch Elevation in Trangendered Patients: Anterior Glottic Web Formation Assisted by Temporary Injection Augmentation