Hold the Phone! Bartonsville Man Can’t Believe He Has His Voice Back

Not long after his vocal fold implant surgery in May, Lester Arenz answered the phone at his Bartonsville home. He picked it up and said hello to his brother, Steve, who thought he had the wrong number.

“I told him, ‘Steve, it’s me,’” says the 79-year-old retiree. “He couldn’t believe it. I hadn’t been able to talk above a whisper for a long time, and now he could hear me speak good as new.”

Arenz’s voice started changing about three years ago. It was a raspy whisper by the time he was diagnosed with esophageal cancer. When he asked his doctors if there was a way of getting it back to normal, he was recommended to Lehigh Valley Health Network laryngologist Mausumi Syamal, MD, with LVPG Ear, Nose and Throat, who specializes in vocal cord disorders.

“It was fantastic,” Arenz says. “Dr. Syamal did a great job. It’s like it never happened. The surgery was a little different though.”

In vocal fold implant surgery, the patient is actually awake so the laryngologist can test the tone and modulation of the voice as well as maintain an adequate airway. The vocal cords (also known as vocal folds) are multilayered structures of skin (epithelium) and connective tissue (lamina propria)

that come together and vibrate when they meet as air passes through the larynx. This creates the sounds we use for speech. They also help to regulate breathing and prevent choking when food or other items pass through the larynx.

When one of the cords is paralyzed by an injury or illness, voice problems such as that experienced by Arenz are commonplace. Initially, Syamal will inject a temporary gel into the affected area, then follow the patient for about a year to see if the cord immobilization disappears. If not, a silicone implant approximately 2 centimeters in size is inserted between the cords to assist them in coming together. 

“At first, every patient wonders a little bit when we tell them about being awake during the procedure,” Syamal says. “But we assure them there is absolutely no pain. We ask patients to say a few words and tell us about their breathing.”

Syamal is one of the few laryngologists in the U.S. who carves her own implants, rather than use premanufactured models. A computed tomography (CT) scan gives her the dimensions within the larynx so she can customize about a half-dozen implants that may be tried during what is generally a 90-minute procedure.

“We’re trying to get the perfect voice for their anatomy,” Syamal says. “Our patients come back for checkups and can’t say enough about how happy they are with their voices. It’s very gratifying for us to be able to help them.”

Elizabeth Arenz, Lester’s wife of 56 years, also was a patient at Lehigh Valley Hospital–Cedar Crest while her husband was having the implant surgery.

“She came to visit me and was shocked to hear me talking again so soon,” Arenz says. “After being unable to really speak for a long time, it’s a blessing to have my voice back. I tell anyone who has a voice problem like I had, go see Dr. Syamal.”