What Are the Risks of Vocal Cord Surgery? Dr. Çağatay Ruhi

Following vocal cord surgery, temporary or permanent hoarseness and undesirable changes to the voice may occur. Issues such as vocal cord trauma, infection, haemorrhage, and, rarely, vocal cord paralysis may be experienced. After vocal cord surgery, a period of vocal rest is absolutely essential to allow the vocal cords to heal properly. If vocal rest is not observed, nodules may recur or a deterioration in voice quality may occur.

Risks and complications of vocal cord surgery

Temporary or permanent changes to the voice: Oedema may develop in the vocal cords following surgery. This manifests as voice cracking, huskiness, or temporary hoarseness. In rare cases following microlaryngoscopy with excision of vocal cord nodules, the vocal cords may be damaged and the voice change may become permanent.

Haemorrhage and infection: As with any surgical procedure, there is a risk of postoperative bleeding or haematoma formation, as well as infection developing at the surgical site following vocal cord surgery.

Vocal cord paralysis: This is an extremely rare occurrence. Following laryngomicrosurgery, damage to the nerves that control the movement of the vocal cords may result in paralysis.

Wound healing complications: Following vocal cord surgery, problems with wound healing and fibrosis at the surgical site may arise.

Recurrence of nodules/polyps: If the surgeon's recommendations are not followed after vocal cord surgery, recurrence of nodules or polyps may occur. To prevent recurrence, patients should refrain from smoking, shouting, and incorrect use of vocal tone.

Sore throat and difficulty swallowing: In the first few days following surgery, patients may experience throat pain, numbness, and difficulty swallowing.

How to reduce the risks of vocal cord surgery

The foremost consideration in reducing the risks of vocal cord surgery is vocal rest. It is of the utmost importance not to speak at all for the period specified by your ENT Consultant following the operation. In situations where communication is unavoidable, writing should be preferred over whispering. Vocal rest typically lasts between three and seven days.

Throughout the recovery period, all behaviours that place strain on the vocal cords should be avoided. Smoking must be ceased and shouting must be avoided. Adequate daily fluid intake should be maintained to keep the throat moist. Alcohol should be avoided. If reflux is present, it should be treated. Warm foods should be consumed. Attending voice therapy also helps to minimise potential risks.

How long do the vocal cords take to recover?

Following vocal cord surgery, the vocal cords generally recover within one week. However, voice therapy should be undertaken in order to achieve the desired vocal tone.

Vocal cord recovery process:

In cases of a common cold or simple laryngitis, three to seven days of vocal rest is sufficient.
In cases of incorrect or excessive vocal use, recovery can be achieved within one to two weeks through voice therapy and vocal rest.
Following microlaryngoscopy with excision of vocal cord nodules, vocal rest is essential in the first few days. Full recovery and normal speech may take ten to fourteen days in most patients.
Following phonosurgery, three to seven days of vocal rest is required. Voice therapy must be commenced from the date recommended by your doctor.
Following vocal cord paralysis, the voice may recover within six months.

Points to note following vocal cord surgery

Refrain from speaking for three to seven days, including whispering. Strict attention must be paid to vocal rest.
Use alternative means of communication such as a whiteboard, mobile phone, or paper and pen.
Consume warm foods.
Keep the throat moist by drinking two to three litres of water daily.
Use air humidifiers to maintain the health of the throat and nasal passages.
Avoid foods and drinks that are very hot, very cold, spicy, acidic, or caffeinated.
In particular during the first week, avoid strenuous exercise and activities that raise blood pressure. Do not lift heavy objects.
Avoid throat-clearing and coughing, as these actions can damage the vocal cords.
Avoid products that irritate the vocal cords, such as tobacco and alcohol.
Begin voice therapy on your ENT Consultant's recommendation in order to learn correct vocal technique.

When should you consult a doctor after surgery?

Following vocal cord surgery, you should seek medical advice if you experience difficulty breathing, severe pain, persistent hoarseness, significant postoperative bleeding, or difficulty swallowing.

What is vocal cord paralysis and how is it treated?

Vocal cord paralysis occurs when the nerve controlling the movement of the vocal cords is damaged, preventing the vocal cord from functioning correctly.

How is it treated?

Vocal cord paralysis may resolve spontaneously within three to six months. Voice therapy may be undertaken to facilitate recovery. In some cases, injection augmentation or surgical intervention may be required.

What are the symptoms of vocal cord paralysis?

Symptoms include hoarseness persisting for more than two weeks, a husky or whispery voice, and difficulty breathing or swallowing.

This page has been written for general information purposes. To discuss your specific situation with Dr. Çağatay Ruhi, please get in touch.