thyroplasty

A thyroplasty is a procedure performed on the vocal cords to help improve your voice.

Your surgeon has recommended that you have this operation in order to improve the quality and tone of your voice. Thyroplasty offers a permanent solution.

Before your operation you will be seen at pre-assessment clinic and will be screened for MRSA with swabs from your throat, nose, armpit or groin. If you have other medical problems, you might also have an appointment arranged for you to see an anaesthetist (the doctor that puts you to sleep for the operation).

Some useful tips.

• Avoid irritants of the voice box eg. Smoking, alcohol, caffeine.

• Make family and friends aware that you will not be able to speak for 1 day – bring a pen and pad of paper with you to the hospital.

• If you have been prescribed reflux medication, make sure you take it regularly.

• Arrange time off work (up to two weeks).

On the day of your operation, you will arrive on the ward where nursing staff will go through some paperwork with you, check your vital signs (blood pressure etc.) and give you a gown and stockings to wear (to prevent blood clots).

Before your operation, you will see your surgeon who will go through the operation and the consent form with you.

You will also see your anaesthetist who will go through how you are put to sleep and answer any questions you may have about this.

A small cut is made, in the skin, in the middle of the neck. A piece of cartilage (from the thyroid cartilage) is removed and a silastic (type of plastic) implant is placed through the cartilage into the voice box. This allows the position of the vocal cords to be changed so that they can come together.

This procedure is usually performed under local anaesthetic but you will be given a sedative so that you are relaxed and sleepy throughout the procedure. When the implant is inserted, a camera scope will then be passed through your nose so that the surgeon can see your vocal cords and check the position of the implant.

Thyroplasty is generally a very safe procedure. However, you should be aware of the following risks.

• Pain. You may have a sore throat afterwards but this will settle in a few days and is helped by simple painkillers such as paracetamol.
• Voice change. This could be temporary or permanent and will be discussed with you before the operation.
• Infection. This is very uncommon but is treated with antibiotics if required.
• Difficulty swallowing. While rare, this may be temporary or permanent.
• Bleeding. This is typically minimal and controlled during the operation.
• Difficulty breathing. This can occur due to swelling after surgery. When severe this requires immediate attention.
• Damage to your lips/teeth/gums from the instruments used (a gum guard is used to prevent this).

0 - 1 day.

• Do not talk, whisper, cough or clear your throat for 24 hours. Use a pen and pad of paper to communicate.

• Use steam inhalation 4-5 times a day for 10 minutes – put boiling water into a large bowl, place your head over the bowl with a towel on top, and breathe in the steam through your mouth.

• Keep well hydrated, drinking lots of water everyday. Otherwise, you can eat and drink normally.

• Avoid smoking.

2 - 14 days.

After the first day of complete voice rest, you may start using the voice very gently and sparingly over the next 10 days. After 2 weeks you can use the voice as normal.

You should also

• Avoid shouting or straining your voice.

• Rest your voice between speaking.

• Use the steam inhalation twice a day.

• Avoid heavy lifting and strenuous activity for 2 weeks.

• Keep the wound dry until the sutures are removed 7-10 days after the operation at your GP surgery.

• If the neck becomes swollen, red, or tender please seek medical attention immediately.