December 21, 2016

Argentine President Undergoes Vocal Cord Surgery

Image by Casa Rosada in Wikipedia
On Dec 20, 2016, media reported that the Argentine President Mauricio Macri underwent a 10 minute office procedure to extract a polyp from the vocal cord.

He reportedly went immediately back to work after the procedure.

The details are sparse and it is unclear exactly what was done to extract the vocal cord polyp.

However, there are only a two ways a vocal cord polyp can be extracted in the office without sedation (that I know of).

1) Trans-nasal endoscopy with polyp extraction using cup forceps through a working channel
2) Trans-nasal endoscopy with laser ablation of the polyp, especially if it was vascular. The laser typically used in this situation is a pulsed-dye laser (PDL)

Given he immediately returned to work, I suspect that a PDL laser was used rather than cup forceps biopsy, because if cup forceps were used to remove the polyp, there would be a period of voice rest which is not necessarily required with PDL treatment.

There's also the timing... cup forceps biopsy is not easy to do in an awake patient and is much akin to playing a video game where one is trying to shoot a moving target precisely. 10 minutes is certainly possible, but more realistically, it probably would take more time than that.

PDL laser does not really require precise aiming. You just shine it in the general vicinity of the vocal cord polyp and fire the laser.

Watch video of how a PDL laser works in this situation.

Sources:
Argentine president undergoes vocal cord surgery. Yahoo News 12/20/16

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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