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Vocal Cord Polyp Removal In Clinic (Transnasal Laryngoscopy for Vocal Fold Polyp)

see also: Polyps Nodules CystsRecurrent Vocal Fold Polyp In-Clinic TreatmentSuperior Laryngeal Nerve Blocks Instruction Video

Modified Operative Note:

Procedure: Trans-nasal flexible resection of right vocal fold lesion along with bilateral superior laryngeal nerve blocks

Preop Diagnosis: Dysphonia, right vocal fold polyp

Postop Diagnosis: Same

Anesthesia: Bilateral superior laryngeal nerve blocks with 1/2 to 1 cc to each side of 2% lidocaine with 100,000 epinephrine, nasal decongestion left side with Afrin followed by 4% lidocaine with 1% phenylephrine spray x2 to the left nostril and then application of neurosurgical cottonoids pledgets soaked in the same

Description of Procedure: Following identification the patient informed consent and a brief timeout the above-mentioned anesthesia was then followed by positioning and forward seated seated with his elbows on his knees allowing for placement of the VT scope through the left nostril with a 25-gauge sclerotherapy needle primed with 4% lidocaine positioned in the channel of the scope to drip the anesthetic onto the supraglottic and glottic larynx and then to the subglottis a total of 2 cc.

Imaging identified a prominence at the midportion of the right membranous vocal fold that was grasped and removed repeatedly with an 3 separate placements of the transnasal flexible scope through grasping, removing and then re-grasping on each placement with an average of 2-3 grasps allowing for smoothing of the contour of the resection without disruption of the remainder of the vocal fold allowing for a good contour.

Mucus accumulation seen in the posterior left glottis at the last visit was not identified and hence not addressed. He tolerated the procedure well was observed in clinic and discharged with follow-up targeted in 6 weeks with request that he call next week for the final pathology report.