Phonosurgery

The phonosurgery is a medical specialty that deals with voting improving operations. It is mainly practiced by phoniatrists and ENT doctors . In contrast to classic ENT medicine, which is more concerned with diagnostic and general therapeutic interventions in the larynx , phonosurgery is specifically treated surgically with regard to voice disorders.

Extended definitions

The term phonosurgery was first used by Hans von Leden and Gottfried Eduard Arnold in 1963. They described "phonosurgery as those operations on the larynx that primarily and exclusively have the improvement or restoration of the vocal function as the main indication". The International Association of Phonosurgeons expanded the description in Abano Terme in 2000 : "Phonosurgery describes a functional surgical procedure that is exclusively or also as a proportion of

• Improvement and / or
• Recovery and / or
• Preservation of the voice and the ability to speak

serves ".

history

The first recorded phonosurgical operation was carried out in Tübingen in 1860 by the surgeon Viktor von Bruns : without any anesthesia, which was not available at the time, he removed a vocal cord polyp from his brother in indirect laryngoscopy using a larynx mirror.

Areas of application

Benign changes such as vocal cord nodules , vocal cord polyps , larynx granulomas or Reinke's edema impair phonation by hindering the vibrations of the vocal fold mucosa. The phonosurgeon removes these changes so that voice normalization can take place again. Another area of ​​application of phonosurgery is for glottic closure insufficiency caused by e.g. B. vocal cord arrest , after damage from intubation , muscle / mucous membrane damage to the vocal fold after infections, etc. By relining with z. B. collagen preparations on the side next to the vocal cord, the lack of closure is eliminated. In the case of permanent vocal cord arrest, the phonosurgeon can re-establish the vocal fold closure in an external surgical procedure: a window in the thyroid cartilage, and thus also the affected vocal fold, is moved to the center by inserting pieces of cartilage, silicone or metal braces. Another area of ​​voice enhancement is the feminization of the voice in male-to-female transsexuals .

These phonosurgical interventions are usually carried out using an operating theater laryngoscope under the operating microscope under general anesthesia . Many of these procedures can also under local anesthesia ( local anesthesia done). This has the advantage that the success of the operation can already be checked intraoperatively with the awake patient through auditory voice assessment and, above all, with stroboscopic control of the vibration behavior of the vocal fold mucosa. While this procedure used to be performed using an operating microscope and larynx mirror , phonosurgical procedures are now performed under local anesthesia under video-laryngostroboscopic control.

organization

In Germany, many phonosurgeons (phoniatrists and ENT doctors) are represented in the German Society for Phonosurgery, in Europe via the Phonosurgery Committee of the European Laryngological Society (ELS) and internationally via the International Association of Phonosurgeons (IAP).

swell

• Markus Hess, Susanne Fleischer, Ulrich Koch: Phonosurgery . In: HÄB . No. 12 , 2003, p. 546–550 ( aerztekammer-hamburg.de [PDF; 1.5 MB ; accessed October 1, 2012]).
• M. Remacle, G. Friedrich, FG Dikkers, F. de Jong: Phonosurgery of the vocal folds, a classification proposal . In: Eur Arch Otorhinolaryngol . tape 260 , no. 1 , 2003, p. 1-6 , doi : 10.1007 / s00405-002-0507-5 , PMID 12520347 .
• Steven M. Zeitels, Gerald B. Healy: Laryngology and Phonosurgery . In: N Engl J Med . No. 9 , 2003, p. 882-892 , PMID 12944575 .
• G. Friedrich, M. Remacle, M. Birchall, JP Marie, C. Arens: Defining phonosurgery: a proposal for classification and nomenclature by the Phonosurgery Committee of the European Laryngological Society (ELS) . In: Eur Arch Otorhinolaryngol . tape 264 , no. 10 , 2007, p. 1191-1200 , PMID 17647008 .
• H. von Leden: The history of phonosurgery . In: WJ Gould, RT Satalov, JR Spiegel (Eds.): Voice surgery . Mosby, St. Louis (USA) 1993, ISBN 0-8016-7454-9 , pp. 65-95 .

Individual evidence

1. ↑ H. v. Leden: The history of phonosurgery. In: RT Sataloff (Ed.): Professional voice - the science and the art of clinical care. Singular Publ. Group, San Diego 1997.
2. ↑ intasp.org: International Association of Phonosurgeons (IAP)
3. ↑ V. Bruns: The first eradication of a polyp in the larynx cavity by cutting without bloody opening of the airways, along with brief instructions for laryngoscopy. Laupp + Siebeck, Tübingen 1862.
4. ↑ elsoc.org: Phonosurgery Committee of the European Laryngological Society (ELS) ( Memento of the original dated December 24, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. 

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !