laryngology & voice surgery

With the Information Technology boom over the last two decades, the importance of voice issues has obviously increased, and that can easily be seen in the large Indian metros. Lifestyle induced issues are also on the rise, and treatment often requires meticulous attention to details, a team approach and trust and patience. Fortunately, that is exactly where we come in.

  • Vocal cord nodules
  • Vocal cord polyps
  • Laryngitis
  • Laryngopharyngeal reflux
  • Motility issues
  • Masses
 
  • Allergies & Asthma
  • Neuropathic Cough
  • Reflux induced Cough
 
  • Laryngospasm
  • Paradoxical Vocal Fold Motion
  • Masses
 
  • Cancers
  • Benign tumors
  • Laryngoceles
 
  • Post surgical or viral
  • Idiopathic
  • Traumatic
 

HOARSENESS

Additional Information

Hoarseness is THE most common laryngeal symptom that we see patients for in our practice. Depending on how long the symptoms have been going on, the reasons can range from a simple inflammation, to nodules, polyps and even cancer.
Management often requires an endoscopic evaluation of the voice box using an angled telescope! (However, this is nothing like the nasal gastroscopy that you may be terrified of and picturing in your head). In about 75% cases this may be all we need, however sometimes further imaging and testing may be required.
TIPS & HINTS
  • DO NOT drink or eat anything at least 45 minutes prior to the appointment
  • If you have had a prior CT scan of the head, bring the CD if it is available.
  • Bring a list of any other medications you may be on currently
 

DYSPHAGIA & REFLUX

Additional Information

Reflux is often associated with heartburn and discomfort following an All-You-Can-Eat buffet. However upto 70% of patients with reflux may not have overt symptoms. Instead they often suffer from a scratchy or irritated throat, dry mouth, excessive salivation, feeling of a lump in the or even hoarseness.
Other causes of dysphagia or difficulty in swallowing include masses or tumors in & around the food pipe, myopathies or pharyngeal or esophageal inflammation. When you visit us for this problem, it is imperative to assess the throat endoscopically to rule out other sinister pathologies. Sometimes further testing, including swallowing function testing & imaging may be necessary. Team work is key here and we will work together to address the underlying issues.
TIPS & HINTS
  • DO NOT drink or eat anything at least 45 minutes prior to the appointment
  • If you have had a prior CT scan of the head, bring the CD if it is available.
  • Bring a list of any other medications you may be on currently

CHRONIC COUGH

Additional Information

Chronic cough is routinely scored as one of THE most annoying symptoms by patients in self-reported questionnaires. Being repeatedly told that it’s “just allergies” does not help either. In truth, there are more than 80 causes of chronic cough, ranging from side effects of medications to a hyper sensitive mucosa that reacts abnormally to even the slightest stimulus.
A painstakingly meticulous history taking & systematically addressing multiple underlying factors is often the most appropriate treatment paradigm. When you visit us for this problem, we will most likely need to look at your throat using an endoscope. However, this is not a painful process like the nasal gastroendoscopy that you (and all of us!!) dread. You may also occasionally need further investigations to rule out rarer pathologies like cough variant asthma etc.
TIPS & HINTS
  • DO NOT drink or eat anything at least 45 minutes prior to the appointment
  • If you have had a prior CT scan of the head, bring the CD if it is available.
  • Bring a list of any other medications you may be on currently
 

DYSPNEA & BREATHING ISSUES

Additional Information

If you are suffering from ACUTE or SUDDEN breathing discomfort, please call us IMMEDIATELY! You may need to be brought to one of the hospitals directly instead of a clinic.
 
YOU MAY NEED URGENT AIRWAY SURGERY to make sure you keep receiving enough oxygen.
 
If you have intermittent choking sensations, or feel like it gets hard to breathe when you climb up stairs, or when you lie down the causes can be myriad including your cardiac and renal functions.
Breathing issues can be physical like something blocking your windpipe (mass, tumor, paralysis of cords) OR functional (paradoxical motion, asthma or laryngospasm.
You will need evaluation & endoscopy to diagnose the underlying causes, and may also need imaging, labs and other ancillary tests. Team work is key here and, as always your well being is more important than your doctor’s ego.
TIPS & HINTS
  • DO NOT drink or eat anything at least 45 minutes prior to the appointment
  • If you have had a prior CT scan of the head, bring the CD if it is available.
  • Bring a list of any other medications you may be on currently
 

TUMORS

Additional Information

Unlike the ear & nose, tumors in the larynx are all too common, and are malignant more often than not. But unlike 15 years back, this does not necessarily translate to disfiguring surgery or a permanent hole in the neck. This is due to paradigm shifting research done by ECOG and RTOG groups including many others. Now, over 90% of patients can be treated with a combination of Radiation, chemotherapeutic drugs and larynx saving LASER surgeries through the mouth, thus avoiding scars and long term complications. Laryngectomies are now reserved as a last resort in patients who have failed our efforts. However, it cannot be stressed enough how critical it is to identify these tumors early and address them.
BEWARE: the only symptom in most cases is hoarseness, and as you can guess, its not rare to have people ignore it, only to end up with advanced lesions when they first come to us.
As always it is critical for your physician to be updated with current concepts so we encourage you to read up & ask us ANY and ALL questions you may have. It would be a privilege to be a part of your team as you win this battle, like you have with so many others!
TIPS & HINTS
  • DO REMEMBER, asking for a second, third or fourth opinion is your right as a patient.
  • If you have had a prior CT scan/MRI of the head, bring the CD if it is available.
  • Bring a list of any other medications you may be on currently
 

VOCAL PARALYSIS

Additional Information

The vocal cords are incredible designs of God: they open when you breathe, and close just enough when you speak. This delicate and fine mechanism is altered if the nerve that supplies the muscles controlling the cords is damaged in some way. This can often be due to tumors, or previous surgery, or even diabetes or other neuropathies damaging the neurons or nerve cells.
Regardless of the cause, if one cord is paralysed, the most common issue is hoarseness or weakness of voice. The treatment can range from tightening the cord, or simply moving it closer to the midline so the other cord can meet it when you try to speak. When these procedures are undertaken correctly, results are usually excellent.
However paralysis of both cords is a difficult disease to manage, and unfortunately there is NO gold standard treatment even today. Nerve transfer surgeries are performed for selected patients with guarded results, and pacemakers are in development & research. Often, patients are dependent on tracheostomas (tracheal opening) & need continuous care. As part of his trainee research Dr. Bhattacharyya was involved in the upgradation and design of a new kind of speaking valve which allow patients to speak more efficiently. We carry great love and respect for our patients who are struggling with this difficult battle & are always happy to see you and establish a care program.
TIPS & HINTS
  • DO NOT drink or eat anything at least 45 minutes prior to the appointment
  • If you have had a prior CT scan of the head, bring the CD if it is available.
  • Bring a list of any other medications you may be on currently
 

DR. BHATTACHARYYA'S SPECIAL SAUCE

All good surgeons can give adequate outcomes 85% of the times, however the unending passion and joy of surgery is striving for the last 15%. That means doing all surgeries under magnification to give you the finest scars possible, using surgical adjuncts to promote healing, reducing your downtime.
 
Dr. Bhattacharyya has trained at many of the premier institutes in India and abroad, including the famed Vanderbilt University, Nashville, TN. Extensive use of endoscopes, tissue glues, stem cell rich substrates to promote healing, usage of nerve monitoring whenever required are all steps we take to ensure we give you the absolute best chance at great outcomes. Do discuss with us in detail about your surgery, and if you would like a complimentary surgical video, where possible.
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