Throat surgeries

- Vocal cord polyps and nodule surgery
Nodules and polyps are growths on your vocal folds which can change the way your voice sounds. They generally develop in the vocal cords of those with significant vocal demands such as singers or teachers, or anyone who overuses their voice. While it may be helpful to assess whether voice use patterns are contributing to the development of the problem, treatment usually involves surgery.

Surgery for vocal cord disorders such as polyps, cysts, Reinke’s oedema and nodules, is usually done by a specialist such as Dr van Lierop using microsurgical techniques because optimal voice outcomes can only be achieved with an ENT surgeon who has specialized equipment, training and experience operating on the delicate vocal cords. Surgery done on the vocal cords is known as phonosurgery. When microsurgical tools are used, it is known as phonomicrosurgery.

Phonomicrosurgery is performed under general anaesthetic in a hospital. During this surgery, microsurgical instruments are used with the help of a microscope to visualise the vocal cords. The growths and lesions found on the vibratory edge of the vocal fold are then carefully removed, helping improve voice function and regain voice quality. You can expect some pain after surgery, but pain medication will be prescribed to help with this. It is vital that you do not speak or use your voice for at least 48-72 hours after the procedure to allow for the vocal cords to heal.

- Cancers of the mouth and throat
Just like any other part of the body, cancer can develop in the oral cavity (mouth) and the upper part of the throat (pharynx). The oral cavity, otherwise known as the oropharynx, includes the lips, lining of the cheeks, teeth, gums, tongue, the floor of the mouth, the back of the throat including the tonsils, the hard and soft palate and the salivary glands. All these areas play a vital role in our ability to breathe, talk, chew and swallow.

Tumours can develop in the mouth (oral cancer) and throat (oropharyngeal cancer) and may be cancerous or benign. Those that are cancerous (malignant) can cause a range of complications and may begin to spread through the lymph nodes. Depending on the location, stage and type of tumour, your ENT specialist will play a vital role in the treatment of various types of cancers that affect the mouth and throat. Depending on the specifics of your case, treatment may involve surgery, chemotherapy, radiation therapy or a combination of these treatments. In some cases, reconstructive surgery may be needed thereafter. The lymph nodes in the neck may also be removed to prevent the spreading of cancer.

- Parotidectomy
A parotidectomy is the removal of part or all of the parotid gland, which is the largest of the salivary glands situated on either side of the face, below each ear branching forward. A parotidectomy may be needed for a tumour of this salivary gland. While most parotid tumours are benign (not cancerous), surgery may be needed to treat some cases of salivary cancer or non-cancerous conditions like chronic infection or obstruction of the salivary gland. Due to the anatomy of the facial nerves near the parotid gland, surgery is handled by an experienced ENT surgeon such as Dr van Lierop to avoid injury to these fragile structures.

Surgery is done under general anaesthesia using a special monitor that indicates when a nerve is stimulated so that injury can be avoided. Your doctor may then choose to do a superficial, total or radical parotidectomy. During the surgery, an incision is made just in front of the ear, in a natural skin crease to hide the scar. The parotid gland is then accessed. A superficial parotidectomy, otherwise known as a partial parotidectomy involves the resection of the parotid gland superficial to the facial nerve, while total parotidectomy is done to remove the entire parotid gland, including the superficial and deep lobe. When the gland, along with the facial nerve is resected, it is known as a radical parotidectomy. A drain will be placed to drain excess fluid and blood and will usually be removed after 2 days. You may be discharged after a short hospital stay, depending on your recovery.

- Submandibular gland excision
The submandibular gland is one of the three major salivary glands, located immediately below the lower jaw. A submandibular gland excision is a surgical procedure in which the submandibular gland is removed. This may be necessary to remove stones in this gland causing obstruction, preventing saliva from being released which allows bacteria to grow. This can lead to pain and swelling of the gland, especially after meals. It may also be done to remove abnormal growths (either benign or malignant tumours) in the submandibular gland, or to treat infections that do not respond to medication.

For this procedure, you will be put under general anaesthetic before an incision is made just below the jawline. Dr van Lierop will then access the gland and carefully remove it. An incision may also be made inside the mouth to gain access to a stone from that angle. You can expect a drain to be placed to help with drainage of fluid, but this will be removed once you wake from the anaesthesia. Once discharged, you can expect a full recovery within a week of surgery.