Advice after your nerve block for surgery
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Thyroplasty is an operation to help patients who have had a paralysed vocal fold, to improve the symptoms of hoarse voice and/or swallowing difficulty.
A paralysed vocal fold means one vocal fold is not moving properly. This means the vocal folds cannot close normally to produce a clear voice.
The operation aims to move the paralysed vocal fold closer to the one which works normally, and therefore close the gap between them when you speak and cough.
How is the surgery performed?
The procedure is carried out in the operating theatre under sedation. Before you have the surgery you may be asked to perform a number of vocal tasks, so that your voice can be assessed.
Before the procedure starts you will be sedated (given medication to make you very drowsy). Local anaesthetic is injected into the skin of your neck and a small cut is made through the skin on the side of the paralysed vocal fold. A small opening is then made in the cartilage of the voice box (the thyroid cartilage).
At this point, local anaesthetic will be sprayed into your nose and a nasendoscope (flexible camera) will be passed through your nose, in the same way as when we examined your vocal folds in clinic.
An implant will be inserted into the opening, aiming to move the paralysed vocal fold over into a position where it can more easily meet the moving vocal fold. When the implant is inserted, you may be asked to speak so that the effect on your voice quality can be assessed.
When the surgeons are happy with the quality of your voice, they will place some stitches in the skin. The whole operation generally takes about 60 minutes.
Are there any risks?
The risks of sedation will have been explained to you when you gave your consent. You may experience some discomfort during the procedure but you will be sedated. Your throat may take 6-8 weeks to heal after surgery, so over this time you should treat your voice with care.
Before your operation
- Avoid smoking and drinking alcohol and if you have been prescribed reflux medication make sure you continue to take it regularly
- Plan to have voice rest after your surgery, i.e., warn your friends and family that you will not be able to speak for 2 days
- Have a pad and pen available to write things down
- Inhale plain steam at least once, but preferably twice a day
- If you can, bring someone with you on the day of the procedure for support. You should be able to go home the same day
- You will be unable to drive home after the procedure, so arrange transport and for someone to stay with you overnight.
Immediately after surgery
- Rest your voice completely for 2 days. Do not speak, whisper, laugh or clear your throat if you can possibly help it. Write things down or send texts
- You may cough a little at first but try to keep this to a minimum
- Once you feel yourself swallowing normally, drink plenty of fluids. It is generally best to avoid caffeinated or alcoholic drinks
- Avoid smoke or any other irritants, i.e., dust/fumes 2 days after your operation
- Keep the volume of your voice at a normal conversational level, and rest your voice if it feels tired. It may take several days for your voice to improve
- Avoid shouting, throat clearing, coughing and whispering
- It is a good idea to keep phone conversations short
- Try to have short periods of voice rest between speaking
- Keep drinking plenty of fluids, preferably water
- The stitches in the skin will need to be taken out 7 days after the operation – this can usually be done by the nurse at your GP practice
- You will normally be sent an appointment to come back to the voice clinic 6 weeks after your procedure, to see how your voice has settled.
Contact us
If you have any queries relating to this information, please contact the Speech and language therapy service.
About this information
Service:
Speech and language therapy
Reference:
VV/047
Approval date:
27 September 2024
Review date:
1 September 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.