医疗新知

The laryngomicrosurgery (LMS) is an operation which uses microscopy to magnify the larynx. Other micro instruments or laser may be applied at the same time during the procedure of LMS.

1. Excision of suspicious lesion：
   (1) vocal cord polyp, nodule or cyst. 
   (2) laryngeal cyst such as epiglottic cyst. 
   (3) laryngeal granulomas. 
   (4) laryngeal papillomas. 
2. Thyroplasty：
   (1) vocal cords injection. 
   (2) arytenoid cartilage replacements. 
   (3) arytenoid cartilage fixation.

1. patients have major systemic diseases like cardiopulmonary dysfunction or coagulopathy.
2. patients are unable to extend neck due to serious humpback or cervical spine injury.
3. patients have improper expectorations for the voice after the technique.

1. All patients would be given general anesthesia with ventilation tube. 
2. Direct laryngoscope is inserted through the mouth. 
3. The larynx or hypopharynx is fully exposed and then microscope is set up. 
4. The lesion is operated with microsurgery instrument or laser.

1. Lips, the gum, or the front tooth injury
2. Soft palate lacerated wound would heal in one week. 
3. Pyriform sinus, pharynx or tracheal perforation rarely happens.
4. Massive hemorrhage may happen; once it occurs, merely minor people, there will be artery ligation through neck to stop massive continuous bleeding. 
5. Laryngospasms may happen, so urgent intubation or tracheotomy should be done.

1. Phonation should be limited for 5 day and the patient must avoid speaking loudly, singing and speak too much. 
2. The patient should avoid irritant, specially smoking. 
3. Besides ordinary food after LMS, patients should drink appropriate amount of water to reduce the feeling of sputum in throat.

中國醫藥大學附設醫院

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