Phonosurgery as a day surgery - Postoperative quality and patient satisfaction

Abstract

Phonosurgery is one of the most suitable indication of day surgery. Under local anesthesia, 260 cases have undergone functional videoendoscopic laryngeal surgery at the Nishi Kobe Medical Center. The transoral approach was adopted for endoscopic monitoring of the vocal folds and voice during surgery. In 225 of these cases, the operative procedure was fully accomplished. In 40 laryngeal polyp cases, good vocal function was obtained postoperatively. Clinical Pathway process has been used for patients and medical staff members at the Day Surgery Unit of Kyoto University Hospital since 2000. Interviews of the patients were conducted by a nurse pre- and post- operatively. The most common complaint was limitation of phonation for 3 to 7 days after operation. In cases with unfavorable postoperative vocal function, medication and/or voice therapy were applied. Informed consent with explanation of the operative procedure and postoperative clinical course is most important for avoiding medical problems with patients. For the best phonosurgery treatment program, a voice care team should be organized to include a speech therapist, anesthesiologist, nurse, and others under the leadership of the otolaryngologist.