Surgical Procedures: Cordectomy

What are vocal cords?

Your vocal cords, also called vocal folds, are bands of smooth muscle. They are found in the larynx (voice box), on top of your trachea (windpipe). Your vocal cords vibrate as air passes through the cords from the lungs. This makes the sound of your voice.

What is a cordectomy?

A cordectomy is a surgery to remove part (partial cordectomy) or all (total cordectomy) of your vocal cords. It is sometimes used to treat cancer. It can be done in a few different ways:

• An open incision (cut) gives a better view of the inside of your body. This can take longer to heal.
• Robotic surgery is being used more often as techniques are getting better and tools are becoming smaller.
• Laser microsurgery causes fewer side effects and has a quicker recovery.

The type of surgery you have depends on many factors, like the type and size of your cancer, your overall health, and your treatment plan. Talk to your surgeon about the type of surgery that is right for you.

What are the risks of a cordectomy?

As with any surgery, there are risks and possible side effects. They can be specific to your situation and the type of surgery you had. You will have changes to your voice after this surgery. How much change you have depends on how much of your vocal cords are removed. Partial removal can cause hoarseness and loss of vocal range. After a total cordectomy, you will be unable to make most vocal sounds.

There are also other possible side effects:

• Reaction to anesthesia. Anesthesia is the medication you are given to help you sleep through the surgery, to not remember it, and to manage pain. Reactions can include wheezing, rash, swelling, and low blood pressure.
• Injury or damage to your teeth, lips, tongue, or palate (top of your mouth). These can be caused by the laryngoscope (scope used to look inside your body and in some cases introduce tools for surgery).
• Bleeding.
• Swelling.
• Changes in how you look.

What is recovery like?

Recovery from a cordectomy depends on the type you have had. The most important part of your recovery is to not use your voice. You should not speak (not even whisper), cough, or clear your throat. Your body needs time to heal after surgery and using your voice can lead to further damage. A speech language pathologist will follow you closely after surgery and give you instructions about when you can start to speak again. If needed, they can also talk to you about communication technologies. These are tools like voice boxes, text-to-speak software, and whisper-amplifying devices that help you communicate (talk) with others.

In addition to not speaking, you may be told to:

• Not do any strenuous activity or lift anything heavy.
• Breathe in steam a few times a day to keep your airway from becoming too dry.
• Take antibiotics as prescribed to prevent infection.

Your provider will be able to give you more information about recovery as it depends on the type of surgery you had.

When should I call my provider?

Your provider will give you specific instructions about when to call their office. Often, you should call if you have:

• More swelling.
• New or worsening pain.
• A fever. Your provider will tell you at what temperature you should contact them.
• Trouble breathing.
• New or worsening bleeding.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.

Be sure to take your prescribed medications as directed to prevent pain and infection. Call your team with any new or worsening symptoms.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.