Laryngeal Papilloma Surgery

Laryngeal papilloma is a wart-like (small rough outgrowth) tumour formation in the larynx (voice box). This may be caused due to a Human Papilloma Virus (HPV) infection of the throat. These tumors are generally non-cancerous and affect the vocal cords. The most common symptoms of this condition are hoarseness of the voice and breathing problems.

Laryngeal papilloma can be managed by surgical removal. Although surgery is the standard treatment, it is not a permanent cure for the disease as some of the cells present in and around the tumour may also get infected with HPV, causing a recurrence.

Procedure

The surgical removal of the papilloma’s is usually performed by a procedure called microscopic laryngoscopy. You will be on general anesthesia throughout the surgery. The laryngoscope (a flexible tube with a light source attached) will be placed into your mouth in such a way that the vocal folds are clearly visible. Your surgeon will also use a microscope or telescope to magnify the operation site and get a closer view of the papilloma’s. A sample of the growth is removed and tested in the lab for the presence of cancer. Then, your surgeon will ensure that as much of the papilloma as possible is removed, causing minimal damage to the surrounding tissue. There are various ways of removing the papilloma’s, as described below:

  • CO2 laser or KTP (potassium titanyl phosphate) laser is aimed at the tumour to vaporize or burn it. This clot and cuts off the blood supplying the papilloma; hence reducing the amount of bleeding.  This technique may injure the adjacent tissues.
  • The papilloma’s can be carefully removed with small cupped forceps and pulled out, causing no damage to any adjacent tissues. However, there a risk of bleeding with this method.
  • A new technique for the removal of papilloma’s uses a special endoscope which shaves and removes the tumors out of the airway. This instrument has a small rotating shaving device instead of the usual microscope or telescope attached to it. This method is quicker, causes minimal bleeding and less damage to the adjacent tissues.

Recovery

You will need to give 7 days of complete rest to your voice box. Talking or whispering after the surgery will delay your recovery significantly and may lead to irreversible scarring and hoarseness of your voice. There are no restrictions on your diet. If your tongue is bothering you, you might have to eat some soft foods until it is better. Normal activities, except for talking, can be resumed once the anesthesia effect wears off. You may begin to speak for 5-10 minutes two weeks from the surgery. Sometimes a course of antibiotics or steroids may be prescribed.

Risks and complications

Some of the major risks of laryngeal papilloma surgery are

  • Sore throat or prolonged hoarseness
  • Altered sense of taste
  • Weakness and discomfort of the tongue
  • Injury to the adjacent tissues
  • Bleeding
  • Chipped or broken teeth (rare)