The nation’s first live internet broadcast of surgery to restore a patient’s voice was completed July 30, 2002, at Wake Forest University Baptist Medical Center. The surgery was performed by Jamie Koufman, M.D., director of the Center for Voice Disorders at WFUBMC. Koufman is one of the world’s leading experts on voice rehabilitation surgery, or what Koufman calls “fixing broken voices.” Gregory N. Postma, M.D., associate professor of otolaryngology and assistant director of the voice center, narrated the surgery. The archived webcast is being offered free for continuing medical education credit as well as viewing by the lay public.
About the Procedure
The surgery is known generally as laryngoplastic phonosurgery, meaning plastic surgery of the larynx to reposition the vocal folds and alter the voice. The procedure is also sometimes called thyroplasty or laryngeal framework surgery.
The surgery scheduled for July 30 is called medialization laryngoplasty with arytenoid adduction. The procedure is used to restore the voice in patients who have lost all or most of their voice due to vocal cord paralysis or paresis (partial paralysis), cancer, intubation or trauma.
During medialization laryngoplasty, a surgical-grade plastic implant is shaped and precisely placed to reposition and strengthen the affected vocal cord. The arytenoid adduction is used if needed to close the back part of the larynx.
A small incision is made over the lower portion of the Adam’s apple (the larynx cartilage). The operation is done under local anesthesia with sedation. The patient remains awake “because vocal-fold repositioning alters the voice, and therefore the surgeon must hear the voice to get the best result,” Koufman said. “These laryngoplasties can be likened to tuning piano strings; if you can’t hear them, you can’t do it right.”
About 2,000 laryngoplasties have been performed at the Center for Voice Disorders (thevoicecenter.com) over almost two decades. Koufman said that patients for this surgery typically have either no voice or speak in a whisper. Following the procedure, she said, more than 80 percent have either normal or near-normal voices.“You don’t know how important your voice is until it’s gone. Voice problems have serious social and professional consequences,” Koufman said.“Voice surgery has evolved tremendously in the past twenty years, and the Center for Voice Disorders has had a leadership role nationally and internationally.”
The webcast of the medialization laryngoplasty will take place at 5 p.m. on Tuesday, July 30, on the Medical Center website: www.wfubmc.edu Within 48 hours, an archived version of the webcast will be available on the internet for viewing anytime during the following year. RealPlayer is required to view the webcast and can be downloaded free by visiting the website.
This is the second live internet broadcast of a surgical procedure at WFUBMC. The first – of deep brain stimulation for symptoms of Parkinson’s disease – took place in April. It can also be viewed on the Medical Center website.
Additional webcasts are planned for 2002 and 2003. More information and schedules will be posted on the website.
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CME Information
CME Registration will be available HERE by clicking "Register and View Broadcast."
Target Audience: Otolaryngologists, Speech Language Pathologists
Learner Objectives: At the conclusion of this continuing medical education activity, the participant should:
1. Be better able to recognize the indications for laryngoplasty as well as its technique and limitations.
2. Be better able to determine the best way to evaluate possible surgical candidates.
Accreditation: The Wake Forest University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit: The Wake Forest University School of Medicine designates this educational activity for a maximum of 1.0 hours in category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the activity.
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Americans Speak Out, Select the "Best and Worst Voices in America" in Online Polling by the Center for Voice Disorders of Wake Forest University
WINSTON-SALEM, N.C. - Results of the first online public opinion poll conducted by the Center for Voice Disorders at Wake Forest University have identified the "Best and Worst Voices in America." News anchors Katie Couric and Diane Sawyer, talk show moderator Sam Donaldson and actress Meg Ryan ranked among the 10 "best" voices in the nation while radio personality Howard Stern, comedians Gilbert Godfried and Joan Rivers, and boxer Mike Tyson placed among the 10 "worst." more
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