Phonomicrosurgery

Steven M. Zeitels

• Before phonomicrosurgery can be performed, there must be a careful consent done, with the surgeon detailing precise goals and expectations of the procedure.
  
• The surgeon should discuss potential changes in the acoustic quality of the voice as well as the effort of phonation and capability of projection of ambient noise. These latter vocal characteristics are highly reflective of the aerodynamic efficiency of the individual’s vocal system.
  
• Ideally, the patient should undergo a full acoustic and aerodynamic assessment by a speech-language pathologist; at that time, further preoperative teaching is done. The patient is prepared for the fact that he or she will be on voice rest for 10 to 14 days if dissection is performed within the superficial lamina propria (SLP) of either vocal fold. Based on the extent of the dissection in one or both vocal folds, the period of voice rest may be longer. We have seen no difficulties with vocalmuscle atrophy or other problems related to voice rest in those patients who have had extended voice rest.