Vocal Surgery for Hoarseness in Children

Doctors may recommend vocal surgery for children with hoarseness that can’t be managed with voice therapy alone. It’s usually recommended only for school-age children who can rest their voices after the procedure.

At Hassenfeld Children’s Hospital at NYU Langone, doctors perform laryngeal surgery—an operation on the larynx, or voice box—in the hospital using general anesthesia. Our surgeons are skilled in using sophisticated, high-precision techniques for removing benign vocal cord lesions, such as cysts. They also specialize in repairing paralyzed vocal cords without causing additional injury to the larynx.

Microlaryngeal Vocal Surgery

Microlaryngeal vocal surgery is a procedure in which surgeons remove lesions, such as cysts or polyps, located underneath or on the surface of a vocal cord. First, the doctor uses a tiny microscope to look into the mouth and larynx by way of a rigid tube called a laryngoscope. Using the microscope, the doctor can obtain a highly magnified view of the lesion causing your child’s hoarseness.

The surgeon makes a microscopic incision in or next to the vocal cord and carefully removes the cyst or polyp underneath, taking care not to cause significant scarring. After the lesion has been removed, the surgeon lays the surface of the vocal cord back into place so that it can heal.

The procedure may take up to one and a half hours, and children usually return home the same day as surgery. The vocal cord usually heals within two weeks.

Laryngeal Reinnervation

Laryngeal reinnervation is a two- to three-hour surgical procedure to treat children with a paralyzed vocal cord. Vocal cord paralysis can occur if one of the two recurrent laryngeal nerves responsible for vocal cord movement becomes injured or stretched during surgery in the neck or chest, after a traumatic injury, or due to a growth on one of the nerves.

In this procedure, the surgeon makes a small incision into the neck and attaches the damaged laryngeal nerve to another working nerve in the neck, restoring a large portion of the voice’s tone and strength after the nerve has regrown. Children typically remain in the hospital overnight.

Our doctors usually recommend resting the voice—speaking softly for only very brief periods—for at least a full week after any type of vocal cord surgery.