If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

Am I a candidate for Laryngeal Framework Surgery?

Question

Pitch Lowering Surgery I am a 38 year-old male with a high-pitched voice, especially over the phone. I found out about you while searching for answers to fixing high pitched voice for men. I saw on your website your replied to a 19 year-old man with a high-pitched voice suggesting Laryngeal Frame Work Surgery.

I live in California and went to a speech therapist, and they told me my voice can be fixed with the surgery. When I went to an ENT doctor he mentioned that my vocal cords seem normal. He said I just have to live with the high-pitched voice and surgery can damage my voice.

But I was somewhat relieved when I found you can fix this.

I wanted to ask you if I can be a candidate for Laryngeal Frame Work Surgery and if there are any risks associated with it ?

Also, I was not able to find out any doctor in California that performs this kind of surgery. Would you know any doctor here in California who is good at performing this surgery ? If not, then I don’t mind coming  to NY for this surgery. Thank you.

Answer

It sounds like you would be a candidate for the surgery. We do recommend evaluation first by a speech therapist with testing of your vocal frequency (natural pitch).

Laryngeal framework surgery is done with local anesthesia as an outpatient.

It involves removing one or two strips of cartilage from the larynx or voice box and allows the vocal folds to relax thereby lowering the pitch.

Certainly, any surgery has risks, and these include that of having a breathy or weaker voice among other unlikely problems. But these should be discussed further with your surgeon time when it’s time to have the procedure done.

I am unsure who does surgery on the west coast. However, I would speak to someone who specializes in laryngology or voice problems rather than a general ear nose and throat physician.

Click here to learn more about voice altering surgery

I hope this helps clear things up.

Robert Pincus MD

If you have a question or concern, send us an email. A doctor from one of our centers will answer your question in confidence. We may post the Q & A on the blog if space permits to help others who may have the same question, but will not use your name.

I have a cyst on my arytenoid (in the larynx or voice box)-

Question:  
Hi Drs.  I have been diagnosed with a mucosal retention cyst on my arytenoid process.  I  know it has been there at least 1.5 yrs (I could feel it when breathing hard – it restricted my breathing) but I just had it checked out recently.  The CAT scan showed it was @1.1 cm in diameter.  My Dr. says I should have it removed and that it is a “simple” procedure.  I am most worried about the general anesthesia and possible damage to my teeth or trachea or wherever else the breathing tube goes.  So 2 questions: 1) Do you think I should get a 2nd opinion?  and 2), are these cysts ever aspirated instead of cut out?  Thanks you so much for your thoughts-

Answer:

The arytenoids are paired cartilages that attach to the back of the vocal cords.   By moving the arytenoids, we move the vocal cords-  apart for breathing and together for speaking.  While there can be a cyst (mucous containing sac) on an arytenoid- one more commonly sees granulomas-  which are areas of inflammation.   Granulomas usually come from reflux-  and treatment for reflux will often get these to resolve without intervention.  Cysts come from tissue getting filled with mucous from one of the many many mucous secreting tiny glands throughout the airway.  Usually after some type of trauma to the tissues-  swallowing the wrong way, acid reflux or some other unknown cause.

While cysts can be tumors or even cancers, this one clearly is felt to be nothing worrisome.  If there is a question of there being a tumor or cancer, clearly one should have it removed.

Otherwise, I would suggest removing this should it be growing or causing symptoms- such as hoarseness, difficulty breathing or discomfort.   Removing the cyst is a relatively easy, quick, simple procedure and can be done by most Ear Nose and Throat surgeons- or by a Laryngologist (subspecialist in voice)   It almost always is done with general anesthesia- and the risks are basically as you describe- but they are quite rare-

Removing the cyst involves taking the top off, so that it drains and heals open.  Usually, this would take a couple of minutes, total.   There is no advantage to to aspirating (suctioning out the cyst) as it is likely to refill- and is not really much less of a procedure.

In general, it never hurts to get another opinion…

I hope this helps clear things up.

Robert Pincus MD

Associate Professor Otolaryngology

NY Otolaryngology Group/ NY Voice Center

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