Artist With Paralyzed Vocal Cords Underwent Surgery While Singing
Marmara University (MU) Pendik Training and Research Hospital Ear Nose Throat (ENT) Diseases and Head and Neck Surgery Clinic Faculty Member Assoc. Prof. Dr. Enver returned to Turkey at his own request after doing a postgraduate specialization on voice surgery at Columbia University in New York in 2019-2020.
Enver, who is the second doctor in Turkey to perform nerve transfer from the neck to the larynx, restored the health of his patient who had to speak with a hoarse voice for 14 years due to vocal cord paralysis and gave hope to hundreds of people.
Assoc. Prof. Dr. Enver performed the surgery of 53-year-old pianist chanter Murat Yörü, whose vocal cords were unilaterally paralyzed due to a previous lung surgery, without putting the patient to sleep.
Speaking to his patient, who is a singer, during the operation, Assoc. Prof. Dr. Enver also made his patient sing during the operation in order to understand the condition of the vocal cords.
Assoc. Prof. Dr. Necati Enver, who fitted his patient with virtual reality glasses (VR) to make him feel comfortable during the operation, has thus put into practice that new technologies can be used in education and patient treatment.
Giving information about the surgery, Enver said that vocal cord paralysis can occur after upper respiratory tract infections due to viruses such as Covid-19 and influenza, especially after lung and goiter surgeries, and that vocal cord filling can be performed in the early period, and vocal cord implantation can be performed after making sure that vocal cord paralysis is permanent when time has passed.
Stating that they placed a silicone implant behind the vocal cord without touching it, just like the breast implant, thanks to this, the vocal cords can touch each other comfortably, do not get tired and do not get hoarse, Assoc. Prof. Dr. Enver conveyed the following information:
“Unlike other surgeries, the operation is performed awake. The patient is in a semi-sleeping position throughout the surgery. At that time, we open the place where we will place the implant in the patient’s neck. Then we talk to the patient while placing the vocal cord implant. The purpose of being semi-awake is to hear the patient’s voice during the surgery. We decide at that moment how much to put and where to place it. If we decide where to place the implant in aesthetic surgeries by looking at the image, we need to decide by looking at the patient’s voice in this surgery. Therefore, it is important that the patient is awake and can talk to us.”
PATIENTS WATCH MOVIES WITH VIRTUAL REALITY GLASSES DURING SURGERY
Stating that the surgery takes an average of 1.5 hours and that it can sometimes be stressful for the patient to lie awake during this time, Assoc. Prof. Dr. Enver gave the following information:
“To reduce this, we use virtual reality glasses with our patients. With virtual reality glasses, patients watch movies, walk in nature, watch the waves. In this way, they spend those 1.5-2 hours more calmly. In this way, the comfort they experience during surgery increases. The surgery becomes more feasible for them, but even in patients who do not use it, the surgery is very comfortable. Our patients say, ‘I am glad I had it.”
Stating that they send patients home in the evening of the same day or the next day since the surgery is semi-awake, Enver continued as follows:
“Since we do not touch the vocal cord itself, we place an implant behind it, our patient is able to speak even after surgery. We want him to speak less for the first few weeks, so that the vocal cord can get rid of the edema. If our patients have a desk job, they can return to work the next day. If they are doing a job where they use their voices, we want them to rest for a week or 10 days.”
Referring to the importance of voice in human life, Enver said, “Voice is so present in every moment of our lives… We use our voice while talking to our spouse, telling a story to our child, going to work, applying for a job, and sometimes even singing to ourselves. In all of these moments, patients experience a deficiency in life. In fact, although they do not have a big problem medically, the unhappiness caused by hoarseness, lagging behind in life, increasing distance from social life cause these patients to always fall behind in life.”
Assoc. Prof. Dr. Enver stated that there is a false belief that “Wait”, “It will pass on its own”, “There is no treatment for this anyway” in a large part of patients with vocal cord paralysis, adding that it is possible to return patients to their voices with the vocal cord implant and that the implant is permanent for life.
MURAT YÖRÜ TOLD ABOUT HIS EXPERIENCES
Murat Yörü, a pianist chanter who underwent surgery, said that he was diagnosed with a congenital hole in his lung 12 years ago and that his vocal cord was paralyzed due to the operation he underwent to close the air leak.
Stating that he went in search after his vocal cord was paralyzed, waited for 3 years and did not have a very detailed treatment, Yörü explained the treatment processes he went through over the years as follows:
“My vocal cords were injected with 2 botox injections. This procedure brought the vocal cords closer together. These materials melted and disappeared over time. When the gap between them increased, my speech and breathing performance decreased due to the inevitable gap in my vocal cord. My biggest problem was breathing. My food was escaping into my windpipe. I applied to different health institutions to overcome these problems. I continued to apply botox once or twice more, but they were not effective over the years. Then we met Necati Enver Hodja at Marmara University. He did botox once. Since it was temporary, he decided on a more detailed botox. He took fat from the belly area and made a more detailed injection. After this process, we decided on nerve transport transplant surgery. Necati Hodja tried to accomplish this surgery in 8-9 hours, but since years had passed, this nerve inevitably decayed or disappeared. It has been 2 years since this surgery and I decided on a vocal cord implant.”
Stating that he was a pianist chanteuse but could not do this profession due to his illness, Yörü said that he had the problem of not being able to find a job and work because people could not hear his voice.
Emphasizing that he was experiencing psychological distress because his voice was hoarse, Yörü said, “The reason I decided on the current surgery is to strengthen the voice, to strengthen the voices in the midlines, to be able to shout at least a little, to make people hear my voice. There are also livelihood problems. It is a difficult period, but I believe I will succeed.”