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Abstract: A 48-year-old male presented with “hoarseness for 1 year and sudden loss of voice after a cold 1 month ago”. After completing fiberoptic laryngoscopy, he was diagnosed with vocal cord polyps. After full communication with the patient and family, we agreed to perform bilateral vocal fold polypectomy and postoperative medication.
Basic information】Male, 48 years old
Disease Type】Vocal fold polyp
Hospital】Northern War Zone General Hospital
Date of consultation】August 2021
Treatment plan】Surgical treatment (bilateral vocal fold polyp excision) + medication (cefuroxime sodium for injection + budesonide suspension for inhalation)
Treatment period】3 days of hospitalization, 1 month of postoperative review
Treatment effect】Good vocal fold movement, hoarseness disappeared
I. Initial consultation
The patient, Mr. Gao, came to our hospital accompanied by his family, and asked about his medical history. The laryngoscopy showed that the mucous membrane of the pharynx was not congested, the vocal folds of the vocal folds were visible as fish belly bulges, the vocal folds were poorly mobile and poorly closed, and the nasopharynx and bilateral pear-shaped fossa were not abnormal. According to the examination results, the patient was diagnosed as vocal cord polyp and was recommended to have surgery.
II. Treatment process
After communicating with the patient and his family, the patient was actively admitted to the hospital. After admission, the relevant preoperative routine examinations, including routine blood and urine tests and lung CT, were completed, and no significant abnormalities were found. After the absolute contraindication to surgery was ruled out, a general anesthetic surgery was arranged and bilateral vocal fold polypectomy was performed under the microscope. After the operation, the patient was given cefuroxime sodium for injection to fight infection, and then nebulized with inhalation budesonide suspension. The patient was also instructed to rest with no sound and practice deep inspiration to prevent bilateral vocal fold adhesions. The patient was discharged after 3 days of hospitalization and was instructed to review 1 month after surgery.
III. Treatment effect
After the patient was awake, the patient was asked to make the “ee” sound, and the patient was able to vocalize without significant hoarseness. On the second postoperative day, the patient was asked to pronounce again, and there was slight hoarseness without respiratory distress, which was considered to be caused by mild postoperative edema of the vocal fold mucosa. The patient was discharged in good condition 3 days after the operation, and came to our hospital for laryngoscopy 1 month later, the results indicated that the vocal cords were no longer obviously congested and edematous, the vocal cords had good movement and good closure, and the hoarseness disappeared.
IV. Notes
We are glad that the patient’s voice returned to normal after treatment. After the patient was discharged from the hospital, he temporarily rested from the voice, took more rest, practiced deep inhalation, avoided eating spicy and stimulating foods, and avoided smoking, drinking alcohol and staying up late to avoid affecting the recovery. Also pay attention to keep warm to avoid upper respiratory tract infection due to cold, which may lead to vocal cord edema. If the condition changes, polyps recur or appear residual, you should go to the hospital immediately to avoid delaying the condition.
V. Personal insight
Vocal fold polyp is a common disease in ENT, and the most important cause is excessive use of voice. Therefore, we must pay attention to the rest of the vocal cords and avoid long time speech and shouting. If hoarseness occurs, it must be treated in time. Early conservative treatment has the possibility of cure, but if it takes too long, it often needs to be dealt with by surgery. Of course, there is no need to worry too much about having vocal cord polyps, as they can be cured after active treatment.