The vocal cords are arranged in the shape of a "V". When breathing, the vocal cords are open to allow air to pass through and down into the windpipe. When talking, the vocal cords come together and vibrate. Click here to watch a video.
When surgery is performed on the vocal cords, one is actually cutting into the actual organ that allows one to talk and make other noises.
As such, the care required after vocal cord surgery requires the elimination of any activity that may lead to damage to the surgery site and allow proper and safe healing.
I should mention that the following instructions are our opinion. Other laryngologists may have different after-care instructions.
Strict Voice Rest!
This means absolutely no talking and whispering. Such activities cause the vocal cords to come together and "bang" against the surgery site. I even instruct patients to avoid even mouthing words as it causes the brain to "think" you are talking even if you are not. Essentially, the lips should always remain closed except when eating/drinking.
The analogy would be if you have surgery done on the heel of your foot, you should not walk or put any weight on the heel, otherwise risk improper healing.
Strict voice rest typically lasts for 1-2 weeks after surgery [link]. More recent small studies suggest that voice rest can be for even a shorter duration (a few days) as long as under the guidance of excellent follow-up voice therapy. Check with your surgeon on the exact appropriate duration.
During this period of time, patients typically will email, text, or write on a clipboard if anything needs to be communicated. With smartphones and iPads, one can also purchase a text to speech app of which there are now many (just do a keyword search).
No Coughing or Throat-Clearing
Just as with talking, coughing and throat-clearing also causes the vocal cords to come together and should be avoided if at all possible. Narcotic strength cough-suppressants (ie, hycodan) are often prescribed to help suppress the urge to cough.
Take Reflux Medications
Reflux medications should be taken both before and after surgery to prevent any possibility of acid damage to the surgery site. Such medications should be taken EVEN IF you do not have any symptoms of acid reflux. I typically recommend patients to start such medications one week before surgery and to continue for as long as 3 months after surgery.
Voice Therapy
Voice therapy is recommended before surgery so that patients will understand what and how they are supposed to talk once cleared to do so after surgery. It's much easier to answer questions and practice proper talking technique before surgery rather than after surgery when you are on strict voice rest!
The rationale for voice therapy is to prevent continued phono-trauma to a freshly healing surgery site on the vocal cord. Often, if improper talking technique persists after surgery, the surgery site becomes damaged again or heals with abnormal scar tissue leading to the possibility of needing surgery again.
Voice therapy minimizes the likelihood of needing repeat vocal cord surgery in the future!
Restricted Voice Rest
Once the period of strict voice rest ends, the patient is slowly allowed to talk under voice therapy guidance. From this point forward over the next 4-6 months, the patient is under restricted voice rest.
Restricted voice rest is a fairly broad phrase, but essentially means to:
• NEVER abuse the voice (ie, yelling, screaming, loud talking, etc)
• Talk only when you must (ie, no social talking)
This period of restricted voice rest is important because it allows time for the new vocal cord tissue that has developed to not only heal, but also strengthen. Abusing the voice may tear the freshly healed surgery site which must be avoided at all costs!
54 comments:
hi, i had a microlaryngoscopy 2weeks ago.my doctor removed some nodules and polyps.said he kind of scraped the cords.. i ried resting my voice however im 34 w 4 kids...very hard to do..i was told dont whisper.. so i did use my voice however had to push it out... now its been 2 weeks and if i softly try to use my voice,not whisper..nothing cpmes out.still sounds likea whisper.is this normsl at this point or should it have come back normal by now? im getting nervous that maybe i damaged something permanently. is this possoble or do i just need more time?
I would like to know the answer to your question because I am having this same surgery on April 10 and I am a nervous wreck. First of all I am a smoker. I have cut back but not completely. Second, my job requires a lot of talking. So how long did it take you to talk normal? Please let me know ok. Thank you very much.
I had the surgery on Feb 27 14, I have 3 kids and used my voice within days to make them settle down, healing is a long slow process, and healing with children is even longer, so i recommend you tell them when ever they hear your voice, its time out time. as far as you not speaking, go see the dr. ... The surgery was a success but even today i am still in recovering only getting the full vocal range back about 2 weeks ago, i still expierence a shortness of breathe, could be unrelated but surgery is not scary and its painless, especially if you dont talk after ward . I say it should take 6 months to be completely normal after.
I have just had vocal surgery today. I was appalled at the lack of information given to me prior and after surgery(so websites like this have been so helpful) they told me I could talk after 3 days, which in my mind is ridiculous, considering what I have read. I had one acid reflux tablet given to me pre-op and none after. The nurses did not know what op I had done so asked me questions, forcing me to whisper, on numerous occasions. I had brought a pad and pen and was told I could not bring it with me and my mother was not allowed to wait for me in the after care ward with my belongings. Appalled with Coventry university hospital today, the nurses were lovely but the system has let me down. I really hope the constant acid and whispering straight after op hasn't affected the healing process. I work in a special needs school, where talking is a must and a lot of the time at a loud level. I currently have 2 weeks off but I'm thinking I will need 3, so I don't put myself in a funny position? Thanks
Hey, I you have Android phones, I use Type and Speak, which is free. My doc liked the idea so much he wants to recommend it to all of his patients. I'm using it now. It is hard to scold to your kids with it tho. My daughter keeps laughing when I use it. It actually is becoming a game with the two of us but at least I have a "voice".
I recently had vocal cord surgery, July 18th. After the surgery my doctor told me to speak only 3-4 minutes every hour. Do not yell, do not scream, do not whisper, and do not over use my vocals. I am a fitness instructor so I am allowed to use a mic which I turn all the up so my participants can hear me and I am not yelling. At this time, I am seeing a Speech Therapist, who is great! I am not ALLOWED caffeine, no chocolate, no acidity foods, such as oranges, pineapples, tomatos, etc. Sleep with my held six inches up. I am not on acid reflux meds as long as I do what I am told. I feel great and my participants understand. There were two days apart that I found myself talking way too much.
Boy do I wish I had seen this before surgery. I am a singer and I have undergone it Feb. 3rd, and after a solid 10 days of complete vocal rest (ok I cleared my throat a few times) I went back to work, and now, my throat hurts and I'm pretty sure I messed up what had started healing. This is a serious intervention that would require people knew how long the recovering process can be and how dedicated they must be in order to respect the healing conditions.... I hope it's not too late for me!
I had surgery March 30th I didn't know how important it was to rest my voice. With no pain or discomfort I was talking several days later and teaching 10 days later. However I can tell when I have talk to much, I pray I didn't have have a set-back. I am ready to be healed. any comments please respond!
Denise, I am in the same boat as you, had my surgery 2 days ago, I am very swollen and sore, smoker as well (trying hard not to be). My job requires a lot of talking as well. I have 2 weeks off, hoping it will be enough. How have you healed?
I had surgery on June 8, 2015, in Atlanta, to remove a polyp from my right vocal cord. The surgery went well. The Dr. did not remove the small reactionary bump on the left vocal cord because it should heal itself eventually. The confusing thing for me was the pre op nurse said rest the voice 1 week or so, but the Dr. said rest the voice for about 48 hours, concerned that atrophy might set in if I don't use the muscles for an extended period. So, after 48+ hours or so, I uttered a few words to my family, and my voice felt ok and easy, but then strain, discomfort, and a burning sensation on the right side of my throat. It scared me! Right then, I re-committed myself to rest for 1 full week or longer, maybe even until I return for my post-op appointment on June 17. I hope 48 hours wasn't too prematurely to speak. I pray my voice heals completely. I've kept my mini white board and marker handy ever since. This site has been very helpful in educating me.
I had a my vocal cyst surgery on 20th july and asked to go for the voice rest for 10days . I didnt spoke for 10days . Now started talking a bit but till today am not able to speak clearly with my full range. I am really scared . Please answer me how long this takes to heal completly . After how many days i will get my full voice range. Please answer me
Are you having voice therapy? If so, I suggest you get in contact with your speech therapist. If you're at all interested.. I am an opera singer and had the surgery last week.. have started a blog which you can read here at http://onecordtoofar.blogspot.co.uk/
hope all goes well with your recovery x
I hope you don't mind me asking how you are getting on now? I had the op last week. My surgeon told me 48 hours, yet my speech therapist said 7 full days. I was torn between the two, but being an opera singer I decided to go for the longer one. Spoken today for the first time and the voice feels very hoarse. Would be interested to know about your recovery if you don't mind? I have started a blog also, if you're interested http://onecordtoofar.blogspot.co.uk/. All the best.
Hi, did you get an answer on this? I had my surgery last tuesday and spoke today for the first time. Feels very hoarse, lots of phlegm. As far as I am aware it is normal for it not to 'feel normal' when you first start speaking again. Would be interested to know about your recovery if you don't mind. I have started a blog if you're interested. http://onecordtoofar.blogspot.co.uk/ All the best
I am scheduled to have this surgery next week. I had to go through 6 sessions of speech therapy before they would even schedule the surgery so I could learn good vocal hygiene. I will have 3 weeks off work, which according to everything I just read, is probably good. I talk all day on the phone and to elderly hard of hearing patients. I still drink coffee, that will be hard to give up.
I had surgery in August at a private clinic to remove a nodule that was on one cord. I received no advice as to after care only that I should come in for a follow up appointment 6 weeks later during which he found that the nodule had returned but in a different form. From straight after my surgery I was talking, debating in meetings, raising my voice, etc, etc, as one does. I had noticed that within 2 weeks of my surgery my voice had gone gruff again.
At the follow up session, he the surgeon looked inspected the cords and looked surprised and perplexed. He made a drawing of what it looked like, this time not a nodule on one cord but drew a circular motion around the 2. His advice was to take reflux tablets for 7 weeks and come back in to review. I am 2 weeks into this and extremely concerned.
Had surgery yesterday. Unlike lots of folks on this site, I received a ton of information leading up to the surgery. I was informed that I should rest my voice for 10 full days; no talking, no whispering, no clearing the throat, etc. I was also told to eat soft foods for the 1st couple of days as to not irritate my throat (lots of smoothies).
Never heard about coffee restriction before though!
Hi i just had laser surgery of paralysed vocal
And laser surgery on my voice box i have no idea why i am unable to breathe without assistance as getting no help or info from my surgeon
Hi i just had vocal cords surgery on the 5th of January 2016. I was told no talking for 7 days . No clearing of the throat, or coughing. This is impossible not to coughing. My surgery was very ruff i bleed alot from it. And threw up twice on the way home from surgery. She bruse my mouth very bad i very upset with my surgeon.
Had removal of a large benign polyp on vocal cord two days ago by great doc. Very specific instructions should be provided by doc on voice rest, diet etc. Recommend no coffee or citrus for example or any high acid liquid or food, as can create reflex and acid back up attacking vocal cords which will slow down your recovery. Google acid reflux good food list. Very soft diet first couple days or just liquids will help in recovery also. Day three and haven't eaten much except a pudding, applesauce and bit of mashed potatoes for dinner. Food makes me cough and that is not good.
I had my surgery last week. I have been mouthing words. I have read today I should not have been. I use my voice in my work with developmentally disabled folks. Today my naturally low voice sounds like a sqweek. I was told total voice rest. then i read no cold liquids. It's all /i drink. Iced tea with ice. I'm freaking. And I can't help but cough and clear my throat.
Well I had a nodule removed from one cord 3 days ago, I was not told to stop speaking, in fact I was asked to speak by the nurses. The mouth bruising is from the anaesthetist. They managed to tear some skin off my upper lip, probably used tape, that has cause me more pain. I am not worried about the quality of my voice, but do hope the nodule does not come back. I have acid reflux and have put myself on a strict diet. I received no information from the hospital so I looked it up myself. Problem is the reflux makes you want to clear your throat and it is unbearable not to do so. Not much I can do about that now I read this too late. Oh one thing I found myself. Menthol pastilles for singers work great. Very cooling. Check out your Chemist.
I'm in the process of possibly booking in for this op. Did you guys get this from laryngitis originally?
I had my surgery in India six days ago. I was told no talking at all for three days. Only eat soft food. Nothing acidic. Nothing cold for two weeks. Nothing too hot either. All these restrictions are for two weeks and better if it can be kept up for four weeks. I am told the total healing takes atleast one month. This depends on how much you rest your voice. Reflux medication and antibiotics have been prescribed for one week. Thereafter the reflux medication should be taken for two more months. The reason being that any kind of reflux will irritate the operated area. As far as talking goes, the following restrictions are important:
A) for the first three days no talking
B) after that a little bit of talking but not usual levels for the next 25 days.
C) no whispering, shouting, clearing throat, coughing
D) cough suppressant syrup has been given in case one has cough issues
E) we have to drink lots of water- atleast 2-3 litres a day and keep well hydrated.
F) even after healing it is advisable to always avoid whispering or yelling. Both these are equally bad for the vocal cords.
I am on day 6 and trying to follow these tips! All the best for the surgeries!
I'm scheduled for surgery on May 31, 2016. I have as the doctor put it to many to count large floppy polyps on both sides, he told me my voice should return to normal almost immediately but to restrict talking for 3 to 5 days, I have copd and I still smoke trying to stop but I have been smoking for 42 years and I have a very stressful job I know all excuses but my smokes are my crutch. I'm 52 years old and I have had cancer 3 times in my life wasn't this scared with all of those. I have to talk for my job and I have a 16 year old son. I planned on going back to work the next day but based on all that I have read that's not going to happen. Any comments on how the healing is going with anyone farther out than a few days
I have very large polyps and having vocal cord surgery on June 9th, Some of these post are scary, I'm worried about my throat swelling up. :(
I'm having vocal cord surgery on June 9th 2016 for very large polyps, My question is will my throat swell up? I've been reading these post and some of them sound scary :(
Did your throat swell after surgery?
I had the surgery yesterday (6/6/16). I'm here trying to get answers for my extremely swollen and numb tongue, specifically the right side. Tried a milkshake and it drooled out of my numb mouth. Bit my tongue and cheeks attempting mashed potatoes. Tongue is huge. Persistent cough since surgery also.? Doc pre-advised me no talking for 2 weeks; and soft diet. Nothing else. SMH. I'll be moot for as long as possible. Drink as MUCH water as possible - really.
I had surgery December 2015 I am a Elementary School teacher. I was off for about a month and then worked with a microphone and spoke minimally for the rest of the day. I now have been off on a sabbatical leave for the past year. The days that I have spoken a lot my voice gets tired and my throat hurts. Throat feels constantly dry all the time! I am working at a summer camp and day 1 my throat is very sore. Any hints? I am wondering what I will do once I am back to work?!
Hi, I had vocal chord surgery 11 days ago. Like you a smoker and although cut down drastically find it hard to stop. My voice is still very sparse, and I'me worried that I've caused myself problems? How are you now, and how long before your voice came back, did you continue to smoke? Hope your fully recovered.
There is a program on Iphone. I'm sure its for droind use it too? Test to speech. Ispeech it called. Us this app to talk for you. It will help.
Hi I had a surgery on my left vocal chord due to cyst removal last August 2015. My doctor informed to have my voice rest after, however since I do have kids at home I just rest for couple of days only and started talk slowly. I don't undergo voice theraphy due to financial problem and it was not already covered by my health insurance. Rigth now I'm experiencing dis comfort of my vocal chord and my voice was not yet fully recovered. Whenever I try to sing I cannot reach the high notes anymore. Also, when talk constantly I experience a horseness of my voice. Please advise me on what should I do, most especially I am now a trainee for a call center job and it is purely voice account. I will wait for your repsonse. Thank you.
I just had a vocal chord polyp removed off of my right vocal chord on Monday oct 4th I coughed a few times. Which I know shouldn't be done but I couldn't help it. I drink lots of water at least 5-7 bottles a day and was told no talking or whispering for a full week because I'm a singer usually it's 3-5 days.
Denise can u tell me how well u healed and if u still smoke. I'm in the exact same boat as u and I'm having this done in a couple weeks I'm so scared I need my voice for work as well wondering if I should wait till after Xmas pls help
I had laser on my vocal cords a month ago.. am still waiting for my voice to cone back.. am not sure how long it will take though it hoarse now
Are you better now? I had three polyps removed non cancerous. Very blessed, I'm just concerned when or will I get my voice back? Surgery performed 3 weeks ago.
I had 17 very large floppy polyps removed 5/31/2016. I had my voice back within about 5 days, still smoking had my last recheck last month released me. If you are having any issues please contact your ent. Everything went well for me
Hi! I'm a singer and I had surgery on Oct 10, 2016 for a cyst on my vocal chords. I saw my vocal chords with my ENT last week and they have healed amazingly. I rested for 3 weeks after my surgery, but they had to cut it out (not only laser) so I think that's why. The recovery process has been long and I still don't have my voice 100% but I know it's getting there. It's very up and down. Some days it feels great and some days I'm struggling. Fatigue is a major issue for me and I need to take time to rest during my week and especially if I am doing a lot of singing/talking. I'm reteaching my self how to sing and speak, so it's a long process but I'm thankful I'm doing this. My main advice is REST as much as you can. Never wait to be sore to rest after surgery. For months you're still healing so make sure you treat your voice like a healing instrument. Good luck!
I had my surgery today. I am a smoker as well. I think it has helped to cut way back ahead of time and I bought the patch to help with nicotine cravings. Best to keep all stress to a minimum. Health food stores have natural things for stress. Flash cards help and a dry erase board. My doc said no talking for 14 days period. They said it depends on severity and location of nodule to how long they recommend no speaking. It seems like this is much more common and serious than most people thought. Good luck to all!!
I just had my vocal cord surgery, not sure which method the surgeon used. I was given speaking restrictions for 3 days, as well as to have a clear liquid diet. After that soft foods plenty of water and rest.
I'm so sore, looking at the position the surgery is done I can see why my neck and jaw is so sore.
My body as well feels so sore, I'm thinking is from the anesthesia. But it's me here thinking why my body feels so sore and tired.
I am a teacher of the Word of God, so I can relate to so many that need their voice to work. But I want to get better, so I have put that aside one day at a time.
I too was given limited information as well, but after reading all your post I am going to ask as many questions on my follow up visit.
Thank you all
I had surgery 2 days ago. Not sure if I had polyps or nodules. Doctor wasn't even around after to tell me any details. When I called the office, they refused to give me his email and had to talk to two nurses before they would put me through to him (regarding meds), and then I had to speak to him (3 people). He told me not to talk but gave me no alteratives. (I don't know if I can use Cloraseptic sore throat spray, but I have been). I also have kids and found myself speaking angrily to them, not sure if you call it a loud whisper or yelling but now I am very concerned because I did not rest my voice post op as told - strict voice rest 3 days post op, I was told(after I woke up from surgery). I was never told before surgery that I would not be able to speak post op, so I wasn't prepared. I wonder how this all, is going to affect my vocal cord recovery and voice in the future. I am scared and cant believe the poor teaching I got. I think if its so important not to use voice after surgery then there should be teaching before surgery on how to cope and be prepared. I would have had my kids somewhere else and got my mind set not to talk/yell. Has anyone else had this problem and if so was everything ok later? Worried and stressed.
I had a cyst removed from my vocal chords about 6 months ago. I still feel tightness and straining in my throat, feels like my throat muscles are very tight. Is this normal? Or is there a new issues that has come up? Stretching and vocal exercises do not seem to help. I would appreciate any tips, suggestions or advice. Thank you!
Hey I had the same surgery as you I'm a singer too, they had to cut the cyst, no laser. I had surgery back in December 19 and still healing its a stressful process, one day I'm good and another I'm like wow I feel like my voice is dropping down, not hoarseness but like when you wake up in the morning, that time of lazy voice, I was wander if you had the same symptoms, and sometimes, some pressure in my neck, or I would call more like tension, but my doctor told me the my chords are healing well so far, but I want to know how you doing now if youre fully recovered.. Thanks
Same to me ", 6 months ago removal cyst, I'm a singer but I feel the same symptoms as you, it worries me a some.. Let me know what your doctor has told you.
Please all join the new facebook group 'VOICE CRASH' where there are people discussing and offering advice re their voice issues including post op recovery.
Had my surgery last July 21 to remove a benign vocal fold cyst. Havent talked for 1 week though im tempted to because of my kid. I tried to sneak some words softly. Im trying to avoid answering phone calls as well, though just now which is 11 days after my surgery, i answered a phone call from a client but i tried very hard not to raise my voice. He thought i was in the meeting because of the manner i talk.
Pray and you will be fine!! I had mine Jan.29 and back to normal. I've quit smoking and started back some. About to quit again, I don't recommend if you are a smoker.
How long after surgery did you wait to smoke again ? Did it have an effect on the healing process ?
Android version is Type and Speak.
Outrageous prices for the ISpeech but thanks.
Jip thats what i did. Had to go back. Smoke buggers the whole process
Do not smoke trust me
I had laser surgery to remove a nodule on my vocal cord. I live in Australia and I'm a professional singer. The surgery was performed 4 days ago. I am taking 40 mg of nessium for reflux plus flixotide inhaler as prescribed by surgeon. I was on voice rest for 72 hours, however I did talk quietly, I have not projected my voice. I have smoked for 50 odd years, stopped smoking 5 years ago by using E-cigarettes which I used for 2 years. After my biopsy performed early Feb findings were keratosis with moderate dysplasia. My voice took 4 to 5 weeks to improve. I am expecting the same recovery period after removal of nodule
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