Care & Treatment

A procedure performed in the office to improve voice by adding bulk to a vocal fold that is weak, partially paralyzed, or bowed. After numbing the throat, material is injected into the affected vocal fold so it can close better during speech.

Botulinum toxin (Botox) is injected into specific voice box muscles to temporarily reduce abnormal muscle contractions, helping improve voice in conditions like spasmodic dysphonia (also known as laryngeal dystonia).

An office procedure in which a thin, flexible camera is passed through the nose into the esophagus to examine for abnormalities such as inflammation, narrowing, or growths — without general anesthesia.

A minimally invasive procedure using a laser to remove small growths (papillomas) from the vocal folds or airway caused by the human papillomavirus (HPV).

Use of a precision laser to treat noncancerous lesions such as polyps, cysts, or abnormal blood vessels on the vocal folds, often improving voice while preserving healthy tissue.

Injection of steroid medication directly into vocal fold lesions or scar tissue to reduce inflammation and improve voice.

Removal of a small tissue sample from the larynx for examination, performed in the office under local anesthesia using a flexible scope.

A swallowing test using a small camera through the nose to watch the throat and voice box while the patient swallows food and liquid.

A flexible laryngoscopy with stroboscopy is a procedure where a thin, flexible tube with a camera is inserted through your nose or mouth to examine your throat and vocal cords. The stroboscopy technique uses a flashing light to provide a slow-motion view of your vocal cords in action, helping your doctor assess their function and identify any issues like nodules or scar tissue.

A superior laryngeal nerve block is a procedure that numbs a specific area of your throat. It can be used to treat chronic cough or to provide anesthesia before an office procedure. During the procedure, your doctor uses a small needle to inject a local anesthetic near the superior laryngeal nerve, located at the top and side of your voice box. In some cases, the local anesthetic may be mixed with a steroid medication.

A delicate surgical procedure performed with the assistance of a microscope to allow for precise removal of noncancerous growths on the vocal folds, such as nodules, cysts, or polyps. The goal is to improve voice quality while preserving as much healthy tissue as possible. The surgery is done under general anesthesia, using specialized microinstruments passed through a laryngoscope placed in the mouth. By maintaining the natural structure and vibration of the vocal folds, phonomicrosurgery aims to restore clear, strong voice production and minimize the risk of scarring. Voice therapy is often recommended after surgery to support healing and prevent recurrence.

A surgical approach designed to remove only the portion of the voice box (larynx) that contains cancer, while preserving as much healthy tissue, voice function, and swallowing ability as possible. Depending on the tumor’s location and size, this may include partial removal of one or more laryngeal structures, performed either through the mouth using endoscopic techniques or through an incision in the neck. The goal is to achieve complete cancer removal while avoiding the need for total laryngectomy (complete removal of the voice box) whenever safely possible. Postoperative voice and swallowing rehabilitation may be part of the recovery process.

A surgical procedure that adjusts the position of one of the small joints in the voice box that controls how the vocal folds meet. By moving this joint into a better position, the paralyzed vocal fold can close more effectively, which often improves voice strength and makes swallowing safer.

A surgical procedure performed through a small incision in the neck to improve voice and swallowing in patients with a paralyzed vocal fold. The surgeon makes an opening in the cartilage of the voice box (thyroid cartilage) and places a custom-shaped implant, often made of silicone or Gore-Tex, to gently push the paralyzed vocal fold toward the middle. This allows the working vocal fold to meet it more fully during speech and swallowing, creating a stronger, clearer voice and reducing the risk of liquid going down the wrong way. The surgery is typically performed with the patient under sedation so adjustments can be made in real time to optimize voice quality.

This is a surgery that can improve the tone, bulk, and vibration of a paralyzed vocal fold without moving its position. The surgeon connects a healthy nerve from elsewhere in the neck (ansa cervicalis) to the nerve of the paralyzed vocal fold. While this does not restore movement, over several months the new nerve supply helps the vocal fold become firmer and more resistant to bowing, producing a stronger, less breathy voice. Reinnervation can be combined with other procedures, such as arytenoid repositioning, to optimize results.

A procedure used to widen narrowed areas of the airway, which may occur in the voice box, just below it (subglottis), or in the windpipe (trachea). Depending on the location and type of narrowing, the surgeon may use inflatable balloons or rigid metal dilators to gently stretch the airway. In some cases, scar tissue is first divided with a laser or specialized instruments before dilation. The procedure may need to be repeated periodically to maintain airway openness, especially if the narrowing is due to chronic scarring or inflammation.

A surgery to enlarge a narrowed airway at the level of the voice box (larynx) and the upper windpipe (trachea). This often involves making an incision in the neck, opening the narrowed segment, and placing cartilage grafts—commonly taken from the patient’s rib—into the airway to hold it open. Laryngotracheal reconstruction may be done in a single operation or in stages, and sometimes requires a temporary breathing tube (tracheostomy) during healing.

An open surgical procedure to remove a damaged or narrowed section of the windpipe (trachea) and reconnect the healthy ends. This restores normal airflow and eliminates the scarred segment. Tracheal resection is most often used for areas of narrowing isolated to the trachea that have not improved with less invasive treatments. In most cases, the airway is reconstructed in a single operation, allowing the patient to breathe normally afterward without a breathing tube (tracheostomy).

This is a surgery similar to tracheal resection, but it involves removal of a narrowed section that includes the lower part of the voice box (the cricoid cartilage) along with the upper trachea. The healthy ends of the airway are then reconnected. Cricotracheal resection is typically used for more severe or complex narrowing that extends up to the vocal folds, and like tracheal resection, it can often be performed as a single-stage reconstruction to restore normal breathing.

A surgical procedure performed through an incision in the neck, usually on the left side, to treat a pouch (Zenker’s diverticulum) that forms at the top of the esophagus. The pouch is typically removed and the tight upper esophageal muscle (cricopharyngeus) is cut to prevent the problem from recurring. This approach is often chosen when the pouch is large or when it cannot be adequately reached with an endoscopic approach through the mouth.

A procedure to widen narrowed areas of the esophagus (swallowing tube) that can cause food to stick or difficulty swallowing. Narrowing may be due to scarring, inflammation, or other conditions. The doctor uses either inflatable balloons or flexible dilators to gently stretch the narrowed segment. Sometimes this is combined with other treatments, such as steroid injections or scar tissue removal, to improve and maintain swallowing. This procedure may need to be repeated to help keep the esophagus open over time.

A minimally invasive surgery performed through the mouth to cut the cricopharyngeus muscle, which sits at the top of the esophagus and can sometimes remain too tight, causing swallowing difficulties. The procedure is performed under general anesthesia using a special scope to expose the muscle, which is then divided (often with a laser) to allow food and liquids to pass more easily into the esophagus.

A surgery performed through an incision in the neck to cut the cricopharyngeus muscle when it does not relax properly during swallowing. This approach may be used if exposure through the mouth is not possible or if the anatomy makes the endoscopic approach less safe or effective. By releasing this muscle, the passage from the throat to the esophagus opens more fully, improving swallowing and reducing symptoms such as food sticking.

A specialized surgical treatment for adductor spasmodic dysphonia (laryngeal dystonia), a neurological voice disorder that causes involuntary spasms of the vocal folds during speech. In this procedure, the surgeon carefully identifies and cuts the nerve branches inside the larynx that cause the overactive muscle contractions. These nerves are then reconnected (reinnervated) to a different, non-spasming nerve to preserve muscle tone and prevent atrophy of the vocal cord muscles. The surgery is performed through a small incision in the front of the neck under general anesthesia. Initially, the voice may sound breathy, but as the reinnervation takes effect over several months, voice strength returns, without the frequent breaks or strain caused by spasms.

A surgical procedure for restoring voice after removal of the larynx (voice box). The surgeon creates a small passage (puncture) between the windpipe (trachea) and food pipe (esophagus) within the laryngectomy opening (stoma). A one-way speaking valve (prosthesis) is placed into this passage. When the patient covers the stoma and exhales, air is directed through the valve into the esophagus, causing the throat tissues to vibrate and produce sound. This sound is then shaped into speech by the tongue, lips, and mouth, allowing for a more natural-sounding voice compared to other post-laryngectomy options.