Abstract
Phonosurgery encompasses a range of surgical procedures aimed at improving voice function, and is broadly categorized into endolaryngeal microsurgery, endoscopic laryngeal surgery, and laryngeal framework surgery. This review outlines the indications, surgical techniques, and clinical outcomes associated with each type. For benign vocal fold lesions such as polyps, Reinke’s edema, and cysts, microsurgical excision under general anesthesia has demonstrated favorable improvements in voice parameters. In Reinke’s edema, a potential role of hypoxia-inducible factor-1α and vascular endothelial growth factor in the pathogenesis has been identified. Vocal fold cysts treated with microflap dissection also showed significant voice improvement across multiple acoustic and aerodynamic parameters.
For laryngeal stenosis, the use of silicone tube stents for the patient with anterior glottic web and endoscopic wedge excision using CO2 lasers for a patient with subglottic stenosis or supraglottic stenosis were effective in maintaining vocal function while minimizing invasiveness. CO2 laser surgery has also proven useful in treating early-stage laryngeal and hypopharyngeal cancer. Vocal fold paralysis or atrophy is commonly treated with injection laryngoplasty, including autologous fat, and may also benefit from type I thyroplasty. Long-term voice outcomes are generally favorable, especially with adequate injection volume in male patients.
Laryngeal framework surgery is employed not only for unilateral vocal fold paralysis, but also for pitch modulation and spasmodic dysphonia. Furthermore, cartilage repair in cases of laryngeal trauma has shown promising results in restoring vocal function. This comprehensive review highlights the current advances and effective strategies in phonosurgery, contributing to improved voice quality and patient outcomes.
