Different types of vocal cord surgery include microlaryngoscopy, medialization laryngoplasty, and reduction laryngoplasty. The type of surgery a person has may depend on the reason for the procedure.

The vocal cords are folds of muscle surrounded by a mucous membrane. They are in the voice box, called the larynx, and vibrate to produce sound.

A person may require vocal cord or laryngeal surgery due to injury, infection, strain, or growths in the area. A person may also undergo laryngeal surgery as part of their gender-affirming care.

There are several vocal cord surgeries available. However, this article will focus on only three types, describing each procedure’s risks, side effects, costs, and recovery timeframe.

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Microlaryngoscopy is a common, typically simple procedure.

During microlaryngoscopy, a doctor views a person’s vocal cords by inserting a laryngoscope through the mouth and into the throat. A laryngoscope is a long, thin instrument with a lens or camera on the end.

The surgery does not require a doctor to make incisions to reach the vocal cords or the voice box.

However, once the doctor can view the vocal folds, they may make incisions to remove tissue, such as nodules or polyps, during the procedure.


A doctor may suggest a microlaryngoscopy to help diagnose a problem with the vocal cords or treat certain issues. They may also use the test to perform a biopsy on the vocal cords.

A doctor may use the procedure as a diagnostic tool if someone has:

A doctor may use the procedure as part of a treatment if a person has:

  • small growths on the vocal cords, such as:
  • granulomas, clumps of white blood cells and other tissues
  • recurrent respiratory papillomatosis (RRP), in which wart-like growths occur on the vocal cords
  • edema, or swelling in the vocal cords


Doctors will usually perform a microlaryngoscopy while their patient is under general anesthesia.

A doctor will place a dental protection device into the mouth to keep the mouth open and protect the teeth, tongue, and lips, and they will insert a laryngoscope through the mouth and into the throat.

The doctor will carefully examine the vocal folds with the microscope or camera and may gently manipulate or move the vocal cords.

If the doctor needs to remove tissue from the vocal cords, they will use thin tools such as a cutter and separator to carefully cut it away. A doctor may also perform surgery with a laser.

After surgery, the doctor may use a gentle suctioning tool to remove any blood or fluid. Most people go home the same day.

Medialization laryngoplasty procedures help improve the structure of the vocal cords, which can help them produce better vibration and sound production.

During the procedure, a doctor may place a permanent silicone or Gore-Tex implant into an area of the larynx. In another form of the procedure, a doctor may inject a temporary filler into the space instead.

People sometimes refer to medialization laryngoplasty with an implant as thyroplasty and with injection as vocal fold injection (VFI) medialization laryngoplasty.


Doctors may use this procedure to treat glottic insufficiency, which means the vocal cords cannot close properly. Glottic insufficiency can affect a person’s ability to breathe and swallow and may affect the sound of their voice.

Glottic insufficiency most often occurs due to:

  • Vocal fold paralysis: Vocal cord paralysis involves complete paralysis, or immobility, of the vocal cords.
  • Vocal fold paresis: In vocal paresis, the vocal cords are weak or partially immobile.

The following factors can contribute to vocal paralysis or paresis:

  • traumatic injury
  • neurological disorders
  • abnormal tissue growth

A doctor may suggest VFI medialization laryngoplasty to provide short-term symptomatic relief for people who are unable to undergo thyroplasty or to delay thyroplasty.


The procedure for medialization laryngoplasty differs depending on whether a doctor is placing an implant or administering injectable fillers.

In a thyroplasty, a doctor will administer local anesthesia and may combine it with conscious sedation.

They will make an incision in the neck and cut through the cartilage to expose the vocal folds. The doctor will place the implant into the paraglottic space, a compartment in the larynx.

In VFI laryngoplasty, a person does not typically have to go to a hospital, and a doctor can perform the procedure in their office using local anesthesia.

The doctor injects into the vocal fold — either via the mouth with a long, curved needle or through the throat — and deposits an injectable filler, such as hyaluronic acid.

A doctor may use a reduction, or feminization, laryngoplasty to reduce the size of structures in the larynx and alter the vocal cords. This can provide a higher-pitched voice.


The procedure, which may involve removing areas of the vocal cords or pulling them to increase tension, can result in a higher-pitched voice.

A person may have the surgery as part of their gender-affirming care.


The surgery involves various stages. Under general anesthesia, a doctor may make an incision in the front of the neck.

The surgery can involve:

  • removing part of the thyroid cartilage
  • removing anterior vocal cords
  • shortening the larynx

Some people may experience side effects or complications after vocal cord surgery, including:

  • injury or scarring of the vocal cords
  • lip, tongue, and tooth damage
  • hoarseness
  • sore throat
  • breathing difficulties
  • difficulty swallowing
  • bleeding
  • swelling
  • risks of anesthesia, such as nausea and dizziness
  • infection
  • voice changes

Medicare may partially cover the costs of some surgeries but may not cover the cost of gender-affirming procedures if they do not deem them medically necessary. Medicare may decide coverage for these surgeries on a case-by-case basis.

The costs of vocal cord surgeries are:

With Medicare, a person may expect to pay $383–$783 for microlaryngoscopy and $760–$1,332 for medialization laryngoplasty.

Vocal cord surgery recovery can depend on several factors, including a person’s overall health and surgery type.

A person may be able to go home the day of the procedure or after an overnight hospital stay. A doctor may prescribe medication to relieve pain and swelling and to suppress coughing.

During recovery from microlaryngoscopy, a person may have to avoid speaking for 7–10 days. They may begin voice therapy around 6 weeks after surgery.

The total length of vocal recovery after medialization laryngoplasty may be about 6 months. A person may recover more quickly from VIF medialization laryngoplasty than thyroplasty.

People should speak with a healthcare professional about recovery for their specific surgery.

It is best to contact a doctor if a person experiences side effects of vocal cord surgery, such as:

  • severe, persistent pain
  • bleeding
  • difficulty breathing or swallowing
  • unusual swelling
  • persistent hoarseness
  • persistent coughing
  • unexpected voice changes
  • signs of infection

Different vocal cord surgeries are available to treat different conditions. For example, a doctor may use microlaryngoscopy to diagnose and treat a variety of conditions, including vocal cord polyps.

A doctor may use medialization laryngoplasty to improve the framework of the vocal cords, which may not be able to close effectively. Reduction laryngoplasty may help modify the pitch of a person’s voice.

Risks involved in vocal cord surgery include unintended voice changes, scarring, bleeding, and infection. A person should contact a doctor if they experience complications after vocal cord surgery.