Fast Facts

Stop medications that cause bleeding 7 days before surgery.

Plan for voice rest (no speaking, time off work) for 4 days after surgery.

Eat as normally as possible while recovering including solid food and vegetables.

Speech therapy and good lifestyle habits for the voice and throat, before and after surgery, helps get the best result for your voice.

mitec-microlaryngoscopy

What is this for and is it effective?

Your surgeon can examine the pharynx (throat) and larynx (voice box) with flexible endoscopes (cameras) in the office but can’t take biopsies or samples while you are awake. Microlaryngoscopy allows the surgeon to look, feel and take samples of these areas.

The vocal cords are delicate and a microscope is used to magnify the surgeon’s view. This leads to more careful surgery with less scarring.

Occasionally the shape of the teeth, jaw and neck mean that the instruments needed can’t be properly inserted and the surgery can’t be completed.

Frequently Asked Questions

What could go wrong? Is there a chance that surgery could make me worse?

Most operations go well and most patients recover fully with an improvement in symptoms. Occasionally side effects or complications happen.

Temporary side effects: 

  • Less than 1:100 patients have bleeding. This usually settles with medication but sometimes return to the operating theatre to stop bleeding is needed.
  • Less than 1:1000 patients develop swelling in the throat that can cause problems breathing. The risk is greatest in the first few hours after surgery and you will remain in hospital for four hours of observation. Medication to reduce swelling and oxygen are used and very rarely a breathing tube needs to be put back in to help with breathing for 24 hours.
  • Less than 1:1000 patients have temporary neck pain.
  • Less than 1:1000 patients get a perforation or hole in the lining of the throat leading to serious infection. This is treated with intravenous antibiotics and surgery to repair the hole, with several days in hospital to recover.

Permanent side effects:

  • 1:100 patients have long term hoarse voice.
  • 1:1000 patients have chipped teeth from pressure from instruments inserted into the mouth.
Could I need more surgery or treatment in the future?

Yes, depending on the underlying problem. Many voice and throat problems recur. Speech therapy and good lifestyle habits for the voice and throat help to prevent problems coming back. Sometimes the biopsy or sample reveals a disease, like cancer, that needs more extensive treatment.

What are the alternatives to surgery? Are they appropriate for me?

Most voice and throat problems improve with speech therapy and good lifestyle habits. Your surgeon will recommend surgery only if non-surgical treatments aren’t effective or if there is a lump or suspected pre-cancerous or cancerous area.

What if I choose not to have surgery?

For patients with a suspected pre cancer or cancer, surgery to get a sample is essential. For mild disease, it may be ok not to have surgery.

See should I have surgery for more information.

How should I prepare for surgery?

Stop using any supplements and medications that increase bleeding (like Nurofen, aspirin, garlic, echinacea) one week before surgery and follow the fasting instructions provided by the hospital.

Stop smoking. Smokers are more likely to have side effects including heart and breathing complications, increased pain and bleeding and take longer to heal. The longer you have stopped smoking, the safer the surgery will be for you. If you smoke on the day of surgery, your surgery will be cancelled. Ask your surgeon for a Quit pack if needed. The nurses can help with nicotine patches while you are in hospital.

Speech therapy, treating reflux and rhinitis and good lifestyle habits for the throat can help with healing after surgery. Keep going with all these good things before and after surgery.

See preparing for surgery for more information.

When will I come into hospital? How long will the operation take? How long will I stay in hospital?

You will come into hospital on the day of surgery. The operation takes 40 minutes. You will go home 4 hours after surgery.

How long will I need off work/school/sport?

You need four days of complete voice rest (no talking at all) and up to one week off work, study and sport. You should not drive for at least 24 hours after a general anaesthetic.

Will I be awake or asleep for the operation? What kind of anaesthetic will I have?

Children and adults always have a general anaesthetic for this procedure.

See anaesthesia for more information.

How will I feel after surgery?

You will have throat pain. Pain lasts for two weeks. It is often mild initially and then gradually feels worse, peaking around 5-7 days after surgery. When throat pain is severe it can also be felt in the ears, tongue and neck.

What do I need to do to recover well?

The better you eat, the better you heal, especially fruit and vegetables. Drink plain water regularly.

 Rest the vocal cords to allow them to heal:

  • don’t speak at all for four days then.
  • speak as little as possible with a normal voice for another 4 days.
  • then return to normal.

Avoid whispering, shouting, throat clearing, coughing.

Continue speech therapy homework if this was started before surgery.

Take Nexium 40mg daily for 4 weeks to reduce acid reflux and help healing. Continue Nasonex or saline sprays and asthma treatment. Restart aspirin the day after surgery if you were already taking it.

When will I see the surgeon?

The surgeon will:

  • Check on you in the recovery room and,
  • See you in the office one week after surgery. You will be given an appointment card today,
  • And again in 6 weeks. This visit will include an awake flexible endoscopy to check healing.
What should I do if I need help or advice?

You can ring the surgeon or practice nurse during business hours on 55605411. For non emergency advice outside business hours, ring the nurse at the hospital where you had surgery. For urgent care outside business hours, attend your nearest emergency department.

Click here for information about Dr Clancy’s on call schedule.

Is there any more information specific to my situation?

Your surgeon will take into consideration your work, sports/hobbies, support at home and other health problems as well as past reactions or complications with anaesthesia and surgery.

Your surgeon will answer any specific questions you ask.

After microlaryngoscopy or endoscopy

You need 24 hours off work, sport and driving after a general anaesthetic. You will need four days of complete voice rest (no talking at all) and one to two weeks off work depending on your treatment plan.

What do I need to do to recover well?

The better you eat, the better you heal, especially fruit and vegetables. Drink plain water regularly.

Rest the vocal cords to allow them to heal:

  • don’t speak at all for four days then.
  • speak as little as possible with a normal voice for another 4 days.
  • then return to normal.

Avoid whispering, shouting, throat clearing, coughing.

Continue speech therapy homework if this was started before surgery.

Take Nexium 40mg daily for 4 weeks to reduce acid reflux and help healing. Continue steroid nasal spray, saline nasal rinses and asthma treatment. Restart aspirin the day after surgery if you were already taking it.

What is normal? How will I feel after surgery?

There may be mild pain and irritation in the throat. The top teeth or gums can sometimes feel sore or bruised. The voice will sound hoarse for 1-2 weeks.

What is not normal?

Contact your surgeon or attend your nearest emergency department if you have:

  • vomiting lasting more than a few hours.
  • severe pain not controlled by the prescribed pain medication.
  • fever >38 degrees for more than 24 hours.
  • pain on swallowing or finding it hard to swallow.
  • coughing up bright blood for more than 5 minutes.
  • noisy breathing or a feeling of restricted breathing.
  • swelling in the neck or pain on moving the neck.
When will I see the surgeon?

The surgeon will:

  • Check on you in the recovery room and,
  • See you in the office one week after surgery. You will be given an appointment card today.
  • And again in 6 weeks. This visit will include an awake endoscopy to check healing.
What should I do if I need help or advice?

You can ring the surgeon or practice nurse during business hours on 55605411. For non emergency advice outside business hours, ring the nurse at the hospital where you had surgery. For urgent care outside business hours, attend your nearest emergency department.

Click here for information about Dr Clancy’s on call schedule.

Is there any more information specific to my situation?

The surgeon will list any information specific to you.

explaining microlaryngoscopy