Advanced Larynx Clinic

The Advanced Larynx clinic is a new clinic run by Professor Sheahan for the assessment, management, and follow-up of patients with laryngeal pathology, including hoarseness, vocal cord nodules, vocal cord dysplasia, and vocal cord cancer.  At the Advanced Larynx clinic, laryngeal assessment is performed with the most advanced Xion videolaryngoscopy system, which utilizes high definition (HD) optics and professional image enhancement technology (PIET) for optimal assessment of the vocal cords and larynx, as well as providing HD videostroboscopy for functional assessment of voice.

The availability of HD and PIET optical technology offers many advantages, including greatly enhanced diagnostic accuracy. In particular, this can aid in the differentiation between low-risk (benign) and high-risk (possibly malignant) vocal cord lesions. This is especially critical in the assessment of patients with leukoplakia (white patches) or other lesions on the vocal cords, as well as in the follow-up of patients with history of vocal cord leukoplakia, dysplasia (pre-cancerous change), or invasive cancer.  The benefit of early recognition of high-risk lesions is the opportunity to perform laser resection while they are still very early stage, giving patients not only the highest likelihood of definitive cure, but also minimizing the morbidity (side effects) of surgery, as the extent of surgery is much less.  At the other end of the spectrum, more accurate recognition of low-risk lesions can facilitate avoidance of surgery, which also has significant benefits to patients, as all vocal cord surgery, even when performed for diagnostic purposes, comes with the risk of causing long-term hoarseness.

For professional voice users, the use of videostroboscopy allows accurate assessment of vocal cord function by using special optical technology to provide a slow-motion view of the vibration of the vocal cords- the so-called mucosal wave.  By analyzing the mucosal wave, it is possible to distinguish between structural causes of hoarseness (which impede the mucosal wave, and which may require surgery), and non-structural causes (which may be best managed by speech therapy). 

The videolaryngoscopic procedure is performed by passing a flexible laryngoscope through the nose.  From here, it is possible to position the camera just above the larynx, and perform the complete assessment.  The tip of the laryngoscope contains a high definition camera, which transits the images to a monitor, which can also record images, so you can also see what the consultant sees. The procedure is not painful, however, prior to the procedure, you may be offered local anaesthetic spray, which also helps to reduce gagging.  If you have local anaesthetic spray, your throat is likely to feel numb for around 20 minutes afterwards, so it is best to avoid eating or drinking until this has worn off.  However, for most patients, the local anaesthetic spray is optional.  The entire procedure should take less than 1-2 minutes, and you will get immediate results. 

Professor Sheahan has extensive experience in management of the patients with hoarseness and Laryngeal pathology, and also has a special interest in management of patients with vocal cord dysplasia and early vocal cord cancers.  He has performed over 500 laryngeal laser procedures, and is an active member of the European Laryngology Society.