When conservative therapy do not result in acceptable voice outcome, a phonosurgical procedures might be discussed. If surgery is needed, we assure you that you are in the best hands. We not only perform all kinds of phonosurgical interventions, but we also train colleagues from all over the world since many years how these procedures result in an optimal outcome.

We offer all operative interventions of phonosurgery.

• Phonomicrosurgery: In general anesthesia, a short and painless procedure where patients are totally asleep, we use microscopes with 25x magnification to remove smallest lesions which are mostly in the order of magnitude of less than one millimeter. This is facilitated with the world’s finest instruments which we gathered to achieve optimal microsurgical results. But not only the removal might be important, but the saving of normal tissues and fibers is of highest priority in phonomicrosurgery. Therefore, removal of small lesions like a polyp, nodule, cyst, pseudocyst, epithelial hyperplasia, Reinke’s edema, scarring, papilloma, hematoma, sulcus vocalis, sulcus vergeture, hemangioma, capillary ectasia, contact granuloma, leukoplakia, biofilm et cetera can take a half an hour or more.

• Office-based surgery: Since the very beginning of our clinical work we have focused on performing painless in-office procedures in topical spray anesthesia. Excision of lesions, reconstruction of vocal fold contours after paralysis, laser surgical interventions or injections  – we offer those interventions in an ambulatory office-based setting and are proud that we can look back on more than 25 years of experience.

• Lasers: In Europe we were one of the first clinics offering photoangiolytic KTP laser surgery. The blue laser (wavelength 445nm) is used routinely since 2016. With ultrathin glass fibers we are able to obliterate finest blood capillaries painless in a non-contact mode during laryngoscopy – in the awake patient. This procedure is not only applicable in recurrent respiratory papilloma (RRP), but also in many other lesions. Within a few minutes the surgery is done – and in some cases never needs a second treatment. In some patients the operation in general anesthesia can be avoided with this therapeutic strategy.

• Injection laryngoplasty (augmentation): Injection with a filler substance such as hyaluronic acid (HA), calciumhydroxylapatite (CaHA), collagen, silicone or other biocompatible implants helped hundreds of patients in cases of glottal insufficiency (when the vocal folds do not close). Many patients with unilateral recurrent nerve paralysis achieved great voices after this kind of injection laryngoplasty. Furthermore, patients suffering from vocal fold bowing (synonym presbylarynx) or patients with vocal fold scarring can significantly benefit from augmentation. We perform those augmentations in an ambulatory setting, either in general anesthesia or in an office-based setting.

• Medialisation thyroplasty: This laryngeal framework surgery enables a permanent medialization of a vocal fold. The implant is placed through an open neck procedure in an in-house setting. Sometimes, we recommend an additional surgery of the arytenoid cartilage, the so called arytenoid adduction.

• BTX-injection: Mostly in patients with spasmodic dysphonia (syn. focal dystonia of the larynx), the laryngeal muscle activity cannot be controlled and needs attenuation by a kind of temporary tonus reduction with BTX. We are able to inject smallest amounts of BTX through a very thin needle into the specific muscles of the larynx – through the neck or indirect transoral or even transnasal. In some cases, we also use laryngeal EMG to guide the tip of the needle into the smaller muscles. Many patients appreciate the short visit and ambulatory injection which sometimes is completed in 15–20 minutes.

• Transgender: As voice specialists and phonosurgeons we are part of the Transgender Board and competence team of the UKE (University Medical Center Hamburg-Eppendorf). Our part is to offer pitch change operations, mostly male-to-female, in these cases.

The MEDICAL VOICE CENTER offers a highly professional interdisciplinary team based on longstanding experience of each team member. We are proud that we can offer almost all procedures in an ambulatory setting – and highly appreciated by our patients. The international networking of our staff includes multiple contacts with voice professional all over the world. Our activities are reflected by multiple memberships in national and international societies (CoMeT, DGE-BV, DGHNO, DGPP, DGP, DBL, EAP, EAV, ELS, IALP, IAP, IFOS, PEVOC, VF, UEP etc.).

Patients receive a differentiated and individualized therapeutical consultation and are introduced to conservative strategies of breathing, intonation, resonance use, posture, voice-imaging. Advantages of osteopathy, homeopathy, nature medicine, logopedics and voice coaching up to phonosurgical methods are addressed.

Conservative Therapy

• Logopedics

• Breathing therapy

• Electrostimulation of the larynx (NMES)

• Osteopathy

• Laryngeal manipulation by Jacob Lieberman

• Manual medicine

• Vocal pedagogy

• Voice coaching

• Voice tuning

• Vocal arts medicine

• Professional voice user rehabilitation (singers, actors, moderators, teachers etc.)

• Vocal hygiene program