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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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MLS Surgery?

Dear Sir I m a renal transplant reciepient from Bangladesh. My transplantation was done 15 yrs. back in Kolkata India. Now my s.creatnine is 2.5 and urea is 74. I m also an insulin dependent diabetic. At this stage I m suffering from hoarseness of voice for 5 months (I/L vocal nodule). My ENT specialist suggested me speech therapy alongwith steam inhalation twice a day. If no relief, he suggests surgery: MLS under GA. Please let me know whether the suggestions are right? Pls. Let me also know is it possible to have surgery in my present fragile condition of kidney? If, the answer is yes than where? Indrajit Kundu (43) Bangladesh
Mon, 7 Nov 2011
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  User's Response
's  Response
Vocal nodules may recur after surgical removal if the underlying cause is not treated. Continue speech therapy for three to six months along with voice rest. Systemic steroids are contra-indicated in your case, but I would explore a trial of supervised local (inhaled) or systemic (monitored) steroid use. Other causes like acid reflux, smoking, allergy, hormonal disturbances or stress must be controlled. General anesthesia is possible in your condition, with a slightly higher risk than in normal subjects. If you are uncomfortable with your hoarseness or if you are a professional voice user, and you decide to undergo MLS, it is a quick and safe procedure. Any major institute in Kolkata is fine. You may consult and take the help of one of the senior-most ENT Specialists in Kolkata: Dr. Anirban Biswas www.anirbanbiswas.com
  User's Response
Indrajit Kundu's  Response
Dear Dr. Sumit
Thanks for your mail. I m not a smoker and there is no problem of acid reflux. But I m on steriod (prednisolone) for 15 years. By profession I m a university teacher. At this stage of my transplant kidney I prefer alternative solutions to surgery. So please let me know about any inhaler or anything else. I shall obey your advice regarding voice therapy and I shall communicate with the ENT specialist in Kolkata. I am now under the supervision of Dr. Saket Aggarwal in Apollo Hospitals, Dhaka. Please let me know your valuable suggestion.
Indrajit Kundu
Bangladesh
General & Family Physician Dr. Jitender Chauhan's  Response
Hello, welcome to Healthcaremagic. Surgery is needed very rarely in vocal nodules. Vocal cord nodules, although they can certainly impair one's speaking and singing ability, rarely harm one's general health. Treatment, or voice rehabilitation, usually involves vocal training, speech therapy, and, occasionally, vocal rest. Removal of vocal cord nodules is a relatively safe and minor surgery. So you must talk to your ENT specialist about the mode of treatment and choose the best option. Wish you good health.
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OBGYN Dr. Nilima Ghosh Hajra's  Response
welcome to healthcaremagic
fnt specialist after examining you has advised you
you can always take second opinion and get another ent doctor's consultation and check up and get tests done as advised
nodules giving rise to hoarseness of voice should be taken seriously and get proper treatment
anaesthtists will do pre anaesthatic check up and take steps for safe anaesthasia in consultation with physicians and other soecialities
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MLS Surgery?

Vocal nodules may recur after surgical removal if the underlying cause is not treated. Continue speech therapy for three to six months along with voice rest. Systemic steroids are contra-indicated in your case, but I would explore a trial of supervised local (inhaled) or systemic (monitored) steroid use. Other causes like acid reflux, smoking, allergy, hormonal disturbances or stress must be controlled. General anesthesia is possible in your condition, with a slightly higher risk than in normal subjects. If you are uncomfortable with your hoarseness or if you are a professional voice user, and you decide to undergo MLS, it is a quick and safe procedure. Any major institute in Kolkata is fine. You may consult and take the help of one of the senior-most ENT Specialists in Kolkata: Dr. Anirban Biswas www.anirbanbiswas.com