Microlaryngeal Surgery (MLS)
Jun 19, 2024![](https://kajabi-storefronts-production.kajabi-cdn.com/kajabi-storefronts-production/file-uploads/blogs/2147545446/images/afbe8-b138-406e-0b47-a3b12b6b1c6f_Concept_Series_website_YouTube_Banner_-13.png)
🌟 What and why? 🌟
MLS consists of the examination of the larynx using an operating microscope +/- excision or biopsy of a lesion. Occasionally, LASER is used. Commonly performed to assess vocal cord mass, but may also be performed for improving vocal cord function.
🔍 Intraoperative considerations: 🔍
📍 Position: Supine with neck extended.
⏱️ Duration: 10-30 mins
🌬️ Airway plan: Microlaryngeal tube (MLT). Consider videolaryngoscope if concerns around laryngeal distortion.
💡 Expert tips:
A 5.0mm MLT is usually suitable and allows the surgeon to gain greater exposure than with a standard ETT. Be aware that ventilation pressures will be higher. If a bougie is required, it is a snug fit with a 5.0mm MLT! Occasionally, the surgeon may need a tubeless field. See our Concept Series article on Tubeless GA for more information!
🌟 Postoperative considerations: 🌟
💥 Pain: Usually minimal. Occasionally moderate pain with vocal cord medialisation.
❗ Airway risks: Bleeding/laryngospasm/swelling in the immediate postoperative period (rare but possible).
🔄 Other:
Often performed as a day case.
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Ref: Turner, Grant, 'Ear, nose and throat surgery', in Rachel Freedman, and others (eds), Oxford Handbook of Anaesthesia, 5 edn, Oxford Medical Handbooks (Oxford, 2022; online edn, Oxford Academic, 1 Nov. 2021), accessed 13 June 2024.