# Vocal Cord Microsurgery

> Vocal cord microsurgery by ENT surgeon Op. Dr. Cenk Teker, Istanbul: nodules, polyps and cysts removed through the mouth under general anaesthesia.

Source: https://www.drcenkteker.com/en/procedures/vocal-cord-microsurgery/  
Updated: 2026-10-29

Ear & throat

Removing nodules, polyps and cysts from the vocal cords under the microscope, through the mouth.

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Performed by Op. Dr. Cenk Teker

Operation time About 1 hour

Anaesthesia General

Hospital stay Usually home the same day

Back to work After voice rest; often about 1 week

Final result Over weeks; assessed at check-ups

The vocal cords are two folds that lie opposite each other in the larynx: muscle inside, covered by a thin, flexible lining. They meet at the front; when you breathe in, the gap between them opens, and when you speak they come together and the air from the lungs sets them vibrating to make the voice. Because that vibration repeats constantly through speech and song, using the voice for long periods, loudly or with poor technique puts the vocal cords under strain.

That strain can lead to benign growths on the surface of the vocal cords: nodules, polyps and cysts. Nodules are callus-like thickenings that usually form opposite each other in the middle of both vocal cords, and they are common in people who use their voice heavily, such as teachers, singers and speakers. These growths stop the vocal cords from vibrating evenly; the voice becomes hoarse and tires quickly, and if the strain continues the hoarseness can become long-lasting.

## When surgery is needed

Hoarseness that has not improved within four weeks calls for an examination of the larynx with a laryngoscope, and sooner in smokers or when there is a sign such as a lump in the neck. For nodules, the first treatment is often voice therapy: learning with a voice therapist to use the voice without strain. Surgery is recommended for growths that cause symptoms and have not improved despite voice therapy and measures to protect the voice, or when the nature of a growth needs to be confirmed. If there are signs of reflux, its treatment is added to the plan.

## What happens in the operation

Vocal cord microsurgery (microlaryngoscopy, MLS) is done under general anaesthesia, through the mouth, with no incision on the outside. A laryngoscope placed through the mouth brings the vocal cords into view, and Dr. Teker removes the growth under the microscope, preserving the vibrating surface of the vocal cord as far as possible. The parts of the larynx and pharynx around the vocal cords are examined in the same session. The operation takes about an hour; after a period of rest in hospital, most patients go home the same day, although this can vary with Dr. Teker’s assessment.

## After the operation

The most important rule is voice rest for as long as Dr. Teker advises, often about a week. During this time, smoking, alcohol and anything that strains the throat are avoided. The voice is then brought back into use gradually, and healing of the vocal cords is assessed at check-ups. Help from a voice therapist to use the voice well, and treatment of reflux when it is present, help to lower the chance of the problem returning.

## Protecting the voice

Surgery removes the growth; it does not remove the strain that caused it. The months after the operation are therefore also a chance to change how the voice is used. Drinking enough water, avoiding smoking and smoky places, keeping talk short or using a microphone rather than raising the voice in noise, resting the voice between long stretches of speaking, and taking vocal tiredness seriously all help to protect the vocal cords. If the voice becomes hoarse again, or a change does not settle within four weeks, another examination is advised.

## Is it right for you?

- Your hoarseness is no longer temporary, and an examination has shown a nodule, polyp or cyst on the vocal cords.
- Your hoarseness has not improved despite voice therapy and measures to protect your voice.
- You use your voice heavily for work: as a teacher, singer or speaker, for example.
- The nature of a growth on the vocal cord needs to be confirmed, or the larynx and pharynx need a detailed examination with a laryngoscope.
- You have an associated condition such as reflux, and its treatment is planned together with removal of the vocal cord growth.

## How the operation is done

1. Examination and diagnosis The cause of the hoarseness is assessed at the consultation by viewing the larynx with a laryngoscope. This shows whether the growth on the vocal cord is a nodule, a polyp or a cyst, and whether voice therapy should be tried first.
2. General anaesthesia The operation is done under general anaesthesia.
3. Access through the mouth A laryngoscope placed through the mouth brings the vocal cords into view. There is no incision on the outside.
4. Removal under the microscope The nodule, polyp or cyst is removed under the microscope, preserving the vibrating surface of the vocal cord as far as possible. The removed tissue is usually sent for pathological examination.
5. Examining the larynx and pharynx The parts of the larynx and pharynx around the vocal cords are examined with the laryngoscope in the same session.
6. Going home After a period of rest in hospital, most patients go home the same day, although this can vary with Dr. Teker’s assessment.

## Recovery, step by step

1. Day 1 Usually home the same day after a period of rest. Voice rest starts straight away. A mildly sore throat or a temporarily numb tongue for a few days is possible.
2. Week 1 Voice rest for as long as Dr. Teker advises, often about a week. No smoking or alcohol, and nothing that strains the throat.
3. The following weeks The voice is brought back into use gradually. Voice therapy starts if needed; if there are signs of reflux, its treatment continues.
4. In the long term Help from a voice therapist to use the voice without strain can lower the chance of the problem returning.
5. Check-ups Healing of the vocal cords is assessed at check-ups, on the schedule Dr. Teker sets.

### A note on risks

Like any operation, vocal cord microsurgery carries a risk of bleeding, infection and a reaction to the anaesthetic. The laryngoscope placed through the mouth to reach the vocal cords can cause small grazes on the lips, tongue or throat that heal within a few days, damage to teeth (especially weak or restored teeth), and temporary numbness or altered feeling of the tongue. While the vocal cord heals, the voice can be hoarse or different for a time; rarely, a scar left on the vocal cord means the voice improves less than hoped. In people who keep straining their voice, who smoke or who do not change how they use their voice, nodules and polyps can form again. Dr. Teker goes through these risks and the rules after surgery with you before the operation.

In every surgical or interventional procedure, results may vary from person to person. Please obtain a detailed opinion from your physician before any procedure.

## Questions patients ask

**What causes hoarseness?**

Most often a passing cause such as a cold, or straining the voice, and it settles on its own. Causes of long-lasting hoarseness include nodules, polyps and cysts on the vocal cords, smoking, reflux, neurological problems and cancer of the larynx. Hoarseness that has not improved within four weeks should be checked by examining the larynx with a laryngoscope, and sooner if you smoke or have a sign such as a lump in the neck. If you suddenly find it hard to breathe, call 112.

**What is the difference between a nodule, a polyp and a cyst?**

Nodules are small, callus-like thickenings that form opposite each other in the middle of both vocal cords. Polyps and cysts are also benign growths and are usually found on one vocal cord. All three are linked to strain on the voice, and they cause hoarseness by stopping the vocal cords from vibrating evenly.

**Can voice therapy be enough instead of surgery?**

For nodules, voice therapy is often the first treatment. Surgery is considered for growths that cause symptoms and have not improved despite voice therapy and measures to protect the voice, or when the nature of a growth needs to be confirmed. Which applies to you is discussed at the consultation.

**How long should I stay silent after surgery?**

For as long as Dr. Teker advises: often about a week, depending on what was removed. Voice rest is one of the most important rules for the vocal cords to heal; afterwards the voice is brought back into use gradually.

**Can the problem come back after surgery?**

It can if the habits that strain the voice continue. Voice therapy to learn to use the voice well, stopping smoking and treating reflux when there are signs of it help to lower the chance of it returning.

Travelling from abroad? How long to stay in Istanbul, the consultation in person and follow-up after you fly home: [International patients](https://www.drcenkteker.com/en/international-patients/)

## References

1. Stachler RJ, Francis DO, Schwartz SR, Damask CC, Digoy GP, Krouse HJ, et al. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update). Otolaryngology – Head and Neck Surgery. 2018;158(S1). [doi:10.1177/0194599817751030](https://doi.org/10.1177/0194599817751030).
2. Naunheim MR, Carroll TL. Benign vocal fold lesions: update on nomenclature, cause, diagnosis, and treatment. Current Opinion in Otolaryngology & Head and Neck Surgery. 2017;25(6):453‑458. [doi:10.1097/MOO.0000000000000408](https://doi.org/10.1097/MOO.0000000000000408).
3. Pedersen M, McGlashan J. Surgical versus non-surgical interventions for vocal cord nodules. Cochrane Library. 2012(6):CD001934. [doi:10.1002/14651858.CD001934.pub2](https://doi.org/10.1002/14651858.CD001934.pub2).
4. Klussmann JP, Knoedgen R, Damm M, Wittekindt C, Eckel HE. Complications of Suspension Laryngoscopy. Annals of Otology, Rhinology & Laryngology. 2002;111(11):972‑976. [doi:10.1177/000348940211101104](https://doi.org/10.1177/000348940211101104).

Medically reviewed by Op. Dr. Cenk Teker, 26 October 2026

## Articles on this subject

[Vocal Cord Microsurgery · 6 min read Hoarseness that does not go away: when to have your larynx examined When lasting hoarseness should be checked, how the vocal cords are examined, common benign causes, voice therapy, and when vocal cord microsurgery is considered. Read more](https://www.drcenkteker.com/en/blog/hoarseness-that-does-not-go-away/)

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## Talk it through with Dr. Teker

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