Summary Endoscopic laryngeal surgery as day-care surgery

Abstract

Endoscopic laryngeal surgery is usually performed under general anesthesia using microlaryngoscope. Hence, the patient must be hospitalized for several days. Generally speaking, in order to let the patient be out of the hospital immediately after the operation, topical anesthesia should be carried out instead of general anesthesia. However, in this case, painful and uncomfortable sennsation can not be avoided to the patient because of using a direct laryngoscope. Avoiding painful and uncomfortable sennsation, a lot of ideas have been developed and reported by many authors. In our clinic, a therapeutic and flexible f iberscope has been developed and applied to remove laryngeal lesions like the vocal fold polyp. From our experience, we indicate that f iberscopic surgery must be performed for small polyps and nodules which are easilly def erenciated from the vocal fold itself. If the surgery is not indicated to restore the normal voice, f iberoptic surgery can be performed, for example, to biopsy for further histopathological study. Even today, fiberoptic surgery should not be applied for polypoid vocal folds, large polyps and so on. And the indication of the f iberopyic surgery is influenced by the patient's occupational reasons. If the patient is a famous opera singer, micro scar formation after the operation must be avoided, which will disturb the musical activity of the vocal foils. In this case, more presice operation must be done under the microlaryngoscope. However, the indication of the f iberoptic surgery will be expanded in future, thanks to newly designed surgical tools like f orseps and laser technique.