[Basic principles for managing and post-operative follow-up in phono-surgery]

The management of the voice in patients with benign lesions of the larynx causing chronic dysphonia follows certain simple rules, on which depend the final functional result. It also requires the closest collaboration between the voice surgeon and the speech therapy team. The indication for surgery rests on the most precise diagnosis of the condition, after examination of the larynx with the rigid endoscope and video-stroboscopy of the cord movements. When a final decision for surgery has been taken, it is essential that the patient should be thoroughly prepared for surgery if the post-operative phase is to pass smoothly, which is the criterion for a good functional recovery. The surgery must be both precise and thorough, with due respect to the structural elements of the vocal folds, and must involve the minimum of resection. Afterwards, a period of complete voice rest is mandatory, before the voice rehabilitation can commence. Finally, post-operative follow-up will be the best guide for selecting the appropriate speech therapy, which will allow the patient to overcome the anatomoical and functional changes brought about by surgery, to recover the potential qualities of his voice, and to resume his vocal and professional activity under the best conditions.