In a remarkable demonstration of advanced medical care and seamless multidisciplinary coordination, a 73-year-old patient regained his voice after nearly 19 years. Dr. Chandraveer Singh, Consultant ENT and Head and Neck Onco Surgeon, along with Dr. Sheetal Radia and their team at Wockhardt Hospitals, Mira Road, successfully performed a complex Type I Thyroplasty procedure to achieve this outcome.
A Rare Complication Following Cardiac Surgery
The patient had lost his voice after undergoing a quadruple heart bypass surgery in 2007. Although the cardiac procedure saved his life, it resulted in a rare but serious complication—damage to the left recurrent laryngeal nerve, which controls vocal cord movement. Consequently, his left vocal cord became paralyzed. As a result, he experienced a weak, breathy voice, significant fatigue while speaking, and persistent difficulty in swallowing. Over time, these symptoms were overshadowed by his multiple health conditions, severely affecting his quality of life.
Managing a High-Risk Medical Profile
The case posed significant challenges due to the patient’s complex medical history. He suffered from chronic kidney disease with elevated creatinine levels, diabetes, hypertension, fluid overload, pleural effusion, ascites, and had previously undergone major cardiac surgery. Therefore, general anesthesia carried substantial risks, making conventional surgical approaches unsafe.
Despite these constraints, the multidisciplinary team carefully assessed the patient and devised a tailored, safer strategy.
Performing Awake Thyroplasty with Precision
Given the high-risk profile, the team opted for an awake Type I Thyroplasty under local anesthesia. During the procedure, surgeons created a small window in the thyroid cartilage and inserted a specialized implant. This implant pushed the paralyzed vocal cord toward the midline, enabling the functioning vocal cord to make proper contact and produce a clearer voice.
Importantly, because the patient remained awake, the team could evaluate his voice in real time. This allowed them to fine-tune the implant placement and achieve optimal vocal outcomes.
Critical Role of Anesthesia Support
As per the press release, Dr. Rohit Kateliya, the anesthetist, played a pivotal role in ensuring the patient’s safety throughout the procedure. By carefully managing the patient’s condition under local anesthesia, he maintained stability despite the high-risk factors, thereby contributing significantly to the success of the surgery.
Expert Insight on Voice Restoration
Reflecting on the case, Dr. Chandraveer Singh stated, “Voice loss after major heart surgery due to nerve damage is rare but life-altering. Many patients learn to live with it, assuming it cannot be treated. However, this case demonstrates that even high-risk patients with multiple comorbidities can safely regain their voice with the right planning, teamwork, and surgical expertise.”
Early Evaluation is Key
Healthcare experts strongly advise that symptoms such as persistent hoarseness, weak voice, or vocal fatigue lasting more than two to three weeks should not be ignored. Instead, individuals should seek timely evaluation from an ENT specialist, as early diagnosis and intervention can significantly improve quality of life.