This chapter focuses on a detailed anatomy of the larynx and the laryngeal structures required for phonation. It also goes on further to discuss the physiology of phonation and how we convert air into words. It describes the necessary requirements to produce voice.

Phonotraumatic lesions causing a voice change are a common finding in ENT practice. Many lesions have been described in literature. Each lesion has its own etiopathogenesis, clinical symptoms, stroboscopy findings and treatment modalities. In this chapter, we describe the etiopathogenesis and management of some of these common phonotraumatic lesions—vocal fold nodules, polyp, vascular lesions, vocal fold cyst, pseudocysts, reactive lesions, contact granuloma, sulcus vocalis and mucosal bridge.

Phonosurgery describes a group of operations performed to improve voice quality. Critical to successful phonosurgery is a sound understanding of vocal fold anatomy and physiology combined with delicate tissue handling and removal of pathology with maximal preservation of adjacent structures. This article describes the general principles of phonosurgery, including indications and preoperative considerations, standard equipment, anesthesia, patient positioning and laryngeal exposure, basic surgical principles, approaches to common pathology, and postoperative management.

Vocal fold paralysis often leads to significant morbidity including dysphonia, dysphagia and aspiration. An appropriate understanding of the pathophysiology, etiologies, and a systematic method of evaluation are essential for discussing prognosis and offering patients appropriate treatments. This article presents a discussion of the most recent literature surrounding vocal cord paralysis, specifically the pathophysiology and different etiologies, and proposes an evaluation strategy involving history, examination and targeted investigations.

Aim: Dysphonia resulting from glottic insufficiency or vocal fold immobility can be a distressing and debilitating condition. The ability to medialize a vocal fold and reposition an immobile arytenoid to allow patients to regain quality, stamina, and reliability of their voice can be achieved through type I medialization thyroplasty with concurrent arytenoid adduction when indicated. Background: Medialization thyroplasty and arytenoid adduction techniques have been honed and reliably performed for decades. The durability of these procedures has been well demonstrated. Additionally, they are routinely performed under local anesthesia with moderate anesthetic sedation enabling frail patients, suffering from glottic insufficiency who are otherwise poor surgical candidates, the opportunity to pursue laryngeal framework surgery and regain vocal strength while risking low overall morbidity. Review results: Understanding how to apply the nuances of these surgeries can yield reliable and successful outcomes. Appreciating these subtle details in the context of the historical development of these procedures is beneficial for any otolaryngologist performing these procedures. Conclusion: Type I thyroplasty and arytenoid adduction procedures have been meticulously refined over time. As a result they are technically elegant and simple procedures that rely on intraoperative precision to optimize postoperative voice outcomes. Disclosures: Please note, this manuscript has not been submitted or presented elsewhere prior to submission here. All authors have no conflicts of interest, sources of external funding related to this publication, or financial disclosures related to this publication to declare.