Whether to remove a cyst at all takes careful consideration, the panelists said. Not every cyst has to be taken out, Dr. Woodson said. Just because you have a cyst there, it doesn’t have to be taken out. The patient has to be ready to take the risk of having his voice be worse in order to undergo the surgery. So the symptoms have to be enough to risk that.
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September 2009That is where intensive voice therapy is crucial, she said. I think they need to really go through a session for voice therapy and see what’s the best voice they can get out of this. So that they can compare that and see, ‘Okay, this is the best voice we can get.’ Then we can make a decision from there about the surgery.
Making matters worse, she said, a lot of times you don’t know what you’re dealing with until you’re in there. Essentially, the cyst is this space-occupying lesion. Sometimes you take it out and you’ve got a big divot left, so I’m very cautious before I go in and operate on a cyst, Dr. Woodson said.
It really comes down to what the patient wants, Dr. Ossoff said. When you’re dealing with professional voices, whether they be singers, broadcasters, or whatever, you almost empower them to tell you, he said. When they don’t know what’s coming out of their mouths, when they’ve lost their confidence…they’ll sort of tell you, ‘I am ready.’
He added, They need to be ready and you can’t talk them into being ready.
Part 2 of this article will feature several case studies involving vocal fold cysts.
©2009 The Triological Society