return to: Vocal Process Granuloma; KTP Laser for the Larynx; Superior Laryngeal Nerve Blocks Instruction Video

Modified Operative Note

Procedure: Transnasal (left) laryngoscopy with KTP lasing (71 joules) to right vocal process granuloma with biopsy (debulking) sent for path

Preop Diagnosis: Right vocal process granuloma

Postop Diagnosis:Same

Anesthesia: bilateral superior laryngeal nerve blocks (2% with 1:100,000) 1 cc to each side; nasal decongestion (left) with afrin, two sprays of 4% lidocaine with phenylephrine, transnasal application of 4% lidocaine through VT scope with 25 gauge sclerotherapy needle 2 cc topically to larynx

Description of Procedure: Following identification of the patient informed consent and a brief timeout in the surgicenter; following the above anesthesia, the VT scope was placed through the left nostril with lateral pressure on the well anesthetized inferior turbinate. 

KTP lasing (61 joules) as KTP 2,3 and 4 to bilobed right vocal process granuloma to base and superficially was followed (withdrawing VT scope to nasopharynx but not removing from nose -permitting straightening) to do two separate passages of biopsy forceps with specimen sent for path

Additional 10 joules of KTP 3,4 to based then done

He was observed in clinic for another 1/2 hour and discharged home with f/u in 1-2 months (he has frequent repeated trips to the Oto clinic and UIHC)