Office-Based Laryngeal Surgery

Preface
Contents
Editors and Contributors
	About the Authors
	Contributors
List of Figures
Part I: Core Knowledge
	Chapter 1: Anatomy and Physiology of the Voice
		1.1 Anatomy
		1.2 Physiology
		References
	Chapter 2: Patient History
		2.1 Patient History
			2.1.1 How Old Are You?
			2.1.2 What Is Your Voice Problem?
			2.1.3 Do You Have Any Pressing Voice Commitments?
			2.1.4 Tell Me About Your Vocal Career, Long-Term Goals, and the Importance of Your Voice Quality and Upcoming Commitments
			2.1.5 How Much Voice Training Have You Had?
			2.1.6 Under What Kinds of Conditions Do You Use Your Voice?
			2.1.7 How Much Do You Practice and Exercise Your Voice? How, When, and Where Do You Use Your Voice?
			2.1.8 Are You Aware of Misusing or Abusing Your Voice During Singing?
			2.1.9 Are You Aware of Misusing or Abusing Your Voice During Speaking?
		2.2 Do You Have Pain When You Talk or Sing?
			2.2.1 What Kind of Physical Condition Are You In?
			2.2.2 How Is Your Hearing?
			2.2.3 Have You Noted Voice or Bodily Weakness, Tremor, Fatigue, or Loss of Control?
			2.2.4 Do You Have Allergy or Cold Symptoms?
			2.2.5 Do You Have Breathing Problems, Especially After Exercise?
			2.2.6 Have You Been Exposed to Environmental Irritants?
			2.2.7 Do You Smoke, Live with a Smoker, or Work Around Smoke?
			2.2.8 Do Any Foods Seem to Affect Your Voice?
			2.2.9 Do You Have Morning Hoarseness, Bad Breath, Excessive Phlegm, a Lump in Your Throat, or Heartburn?
			2.2.10 Do You Have Trouble with Your Bowels or Belly?
			2.2.11 Are You Under Particular Stress or in Therapy?
			2.2.12 Do You Have Problems Controlling Your Weight? Are You Excessively Tired? Are You Cold When Other People Are Warm?
			2.2.13 Do You Have Menstrual Irregularity, Cyclical Voice Changes Associated with Menses, Recent Menopause, or Other Hormonal Changes or Problems?
			2.2.14 Do You Have Jaw Joint or Other Dental Problems?
			2.2.15 Do You or Your Blood Relatives Have Hearing Loss?
			2.2.16 Have you Suffered Whiplash or Other Bodily Injury?
			2.2.17 Did You Undergo Any Surgery Prior to the Onset of Your Voice Problems?
			2.2.18 What Medications and Other Substances Do You Use?
		References
	Chapter 3: Physical Examination
		3.1 Complete Ear, Nose, and Throat Examination
		3.2 Laryngeal Examination
		3.3 Objective Tests
			3.3.1 Strobovideolaryngoscopy
			3.3.2 Other Techniques to Examine Vocal Fold Vibration
			3.3.3 Measures of Phonatory Ability
			3.3.4 Aerodynamic Measures
			3.3.5 Acoustic Analysis
			3.3.6 Laryngeal Electromyography
			3.3.7 Psychoacoustic Evaluation
		3.4 Outcomes Assessment
		3.5 Voice Impairment and Disability
		3.6 Evaluation of the Singing Voice
		3.7 Additional Examinations
		References
	Chapter 4: Professional Voice Users: An Overview of Medical Disorders and Treatments
		4.1 Voice Abuse
		4.2 Infection and Inflammation
			4.2.1 Upper Respiratory Tract Infection Without Laryngitis
			4.2.2 Laryngitis With Serious Vocal Fold Injury
			4.2.3 Laryngitis Without Serious Damage
			4.2.4 Sinusitis
			4.2.5 Lower Respiratory Tract Infection
			4.2.6 COVID-19
			4.2.7 Tonsillitis
			4.2.8 Lyme Disease
				4.2.8.1 Epidemiology
				4.2.8.2 Etiology
				4.2.8.3 Otolaryngologic Findings
				4.2.8.4 Diagnosis and Treatment
			4.2.9 Autoimmune Deficiency Syndrome (AIDS)
		4.3 Systemic Conditions
			4.3.1 Aging
			4.3.2 Hearing Loss
			4.3.3 Respiratory Dysfunction
			4.3.4 Allergy
			4.3.5 Laryngopharyngeal Reflux
			4.3.6 Endocrine Dysfunction
			4.3.7 Neurologic Disorders
			4.3.8 Vocal Fold Hypomobility
		4.4 General Health
			4.4.1 Obesity
			4.4.2 Anxiety
			4.4.3 Substance Abuse
			4.4.4 Other Diseases That May Affect the Voice
		4.5 Structural Abnormalities of the Larynx
			4.5.1 Nodules
			4.5.2 Submucosal Cysts
			4.5.3 Polyps
			4.5.4 Granulomas
			4.5.5 Reinke’s Edema
			4.5.6 Sulcus Vocalis
			4.5.7 Scar
			4.5.8 Hemorrhage
			4.5.9 Papilloma
			4.5.10 Cancer
			4.5.11 Laryngoceles and Pharyngoceles
			4.5.12 Other Conditions
		4.6 Medical Management for Voice Dysfunction
			4.6.1 Speech-Language Pathologist
			4.6.2 Singing Voice Specialist
			4.6.3 Acting-Voice Trainer
			4.6.4 Others
		4.7 Surgery
		4.8 Discretion
		4.9 Voice Maintenance
		References
Part II: In-Office Surgery
	Chapter 5: In-Office Voice Surgery: Basic Principles, Patient Selection, Safety, and Tolerance
		5.1 Introduction
		5.2 Patient Selection and Consent
		5.3 Documentation
		5.4 Timing of Voice Surgery
		5.5 Indirect Laryngoscopy
		5.6 Safety of In-Office Procedures
			5.6.1 Anesthesia Considerations
			5.6.2 Performance of Procedure
			5.6.3 Recovery
			5.6.4 Equipment
		5.7 In-Office Injection
		5.8 Injection of Substances Other Than Botulinum Toxin
		5.9 In-Office Biopsy
		5.10 In-Office Laser Surgery
		5.11 In-Office Laryngeal Electromyography
		5.12 In-Office Tracheoesophageal Puncture (TEP)
		5.13 Patient Tolerance in Unsedated Office-Based Laryngeal Surgery
		5.14 Conclusion
		References
	Chapter 6: Topical Anesthesia in Office-Based Laryngeal Surgery
		6.1 Introduction
		6.2 Topical Anesthesia to the Upper Airway; Anatomic Sites and Methods of Application
			6.2.1 Topical Anesthesia to the Nasal Cavity
			6.2.2 Topical Anesthesia to the Pharynx
			6.2.3 Local Anesthesia to the Larynx
		6.3 Effect of Topical Anesthesia on the Pharynx and Larynx
		6.4 Systemic Toxicity of Topical Anesthesia to the Upper Airway
		References
	Chapter 7: Surgical Techniques and Operative Approaches in Office-Based Laryngeal Surgery
		7.1 Introduction
		7.2 Surgical Technique and Approaches
			7.2.1 The Peroral or Transoral Approach
			7.2.2 The Transcervical Approach
				7.2.2.1 The Transcervical-Cricothyroid Membrane Approach
				7.2.2.2 The Transcervical-Thyrohyoid Membrane Approach
				7.2.2.3 The Transcervical-Transthyroid Cartilage Approach
			7.2.3 The Transnasal Approach Using a Flexible Nasopharyngoscope with a Working Channel
		References
	Chapter 8: Office-Based Injection Laryngoplasty
		8.1 Introduction
		8.2 When to Perform Injection Laryngoplasty?
		8.3 Voice Outcome Following Injection Laryngoplasty
		8.4 Factors Affecting the Outcome of Office-Based Injection Laryngoplasty
			8.4.1 Effect of Age on the Outcome of Office-Based Injection Laryngoplasty
			8.4.2 Effect of Gender on the Outcome of Office-Based Injection Laryngoplasty
			8.4.3 Other Patient-Related Factors in Injection Laryngoplasty
			8.4.4 Technical Factors: Site of Injection, Amount to Be Injected, and Injection Force Mechanics
		8.5 Complications of Injection Laryngoplasty
			8.5.1 Complications of Injection Laryngoplasty Using Collagen
			8.5.2 Complications of Injection Laryngoplasty Using Fat
			8.5.3 Complications Following Injection Laryngoplasty Using Calcium Hydroxylapatite
			8.5.4 Complications of Hyaluronic Acid as a Filling Material in Injection Laryngoplasty
		8.6 New Injection Materials: Prospective and Safety
		References
	Chapter 9: Office-Based Laryngeal Botulinum Toxin Injection
		9.1 Introduction
		9.2 Office-Based Botulinum Toxin Injection in Patients with Spasmodic Dysphonia
		9.3 Office-Based Botulinum Toxin Injection in Patients with Essential Voice Tremor
		9.4 Laryngeal Botulinum Toxin Injection in Patients with Vocal Process Granuloma
		9.5 Laryngeal Botulinum Toxin Injection in Patients with Vocal Fold Dysfunction
		9.6 Rare Application of Office-Based Botulinum Toxin Injection
			9.6.1 Office-Based BT Injection in Patients with Muscle Tension Dysphonia
			9.6.2 Office-Based Botulinum Toxin Injection in Patients with Phonetic Tics
			9.6.3 Office-Based Botulinum Toxin Injection in Patients with Parkinson’s Disease
		9.7 Technique of Office-Based Botulinum Toxin Injection
		References
	Chapter 10: Office-Based Laryngeal Laser Therapy
		10.1 Introduction
		10.2 Review of the Clinical Application of Laser Therapy in an Office Setting
			10.2.1 Office-Based Laser Therapy in Patients with Laryngeal RRP
			10.2.2 Office-Based Laser Therapy in Patients with Benign Vocal Fold Lesions
			10.2.3 Office-Based Laser Therapy in Patients with Dysplasia/Carcinoma In Situ
			10.2.4 Rare Application of Office-Based Laser Therapy
			10.2.5 Office-Based Application of Blue Laser in Laryngeal Surgery
		10.3 Limitations and Complications of Office-Based Laryngeal Laser Surgery
			10.3.1 Limitations of Office-Based Laryngeal Laser Surgery
			10.3.2 Complications of Office-Based Laryngeal Laser Surgery
		References
	Chapter 11: Office-Based Laryngeal Injections of Steroids and Other Pharmaceutical Agents
		11.1 Office-Based Laryngeal Steroid Injections
		11.2 Office-Based Steroid Injections in Laryngotracheal Stenosis
		11.3 Office-Based Vocal Fold Steroid Injection
			11.3.1 Office-Based Steroid Injection in Vocal Fold Scar
			11.3.2 Office-Based Steroid Injection in Benign Lesions of the Vocal Folds
			11.3.3 Office-Based Steroid Injection in Vocal Fold Bamboo Nodes
			11.3.4 Complications of Office-Based Vocal Fold Steroid Injection
		11.4 Office-Based Laryngeal Intra-articular Steroid Injections in Patients with Autoimmune Diseases
		11.5 Office-Based Laryngeal Injections of Cidofovir
		11.6 Office-Based Laryngeal Injection of 5-Fluorouracil
		11.7 Office-Based Laryngeal Injection of Growth Factors
		References
	Chapter 12: Office-Based Laryngeal Biopsy, Excision of Masses, and Dilation
		12.1 Introduction
		12.2 Office-Based Laryngeal Brush Biopsy
		12.3 Office-Based Laryngeal Biopsy
			12.3.1 Diagnostic Yield of Office-Based Laryngeal Biopsy in Patients with Vocal Fold Leukoplakia
		12.4 Office-Based Laryngoscopy and Removal of Lesions
		12.5 Office-Based Laryngeal Dilation
		12.6 Other Office-Based Endolaryngeal Procedures
		References
Index