Nasal endoscopy was performed after conventional intubation with a support laryngoscope, to identify lesions on an imaging system in 23 patients with difficulty in glottis exposure during vocal cord polyp surgery. Appropriate laryngeal forceps were chosen and bent to the required degree, 1-2 cm from the end. They were were then extended into the laryngoscope until reaching the vocal cord polyps. The polyps were then routinely excised, and the edge of the acoustic band was subsequently repaired. Postoperative management included routine intravenous infusion of antibiotics for 3 days and inhalation of budesonide aerosol twice daily for 3 days. The patients were advised 2 weeks of rest, deep breathing, and abstinence from smoking and alcohol.

In all 23 patients, the vocal polyps were excised in the first attempt, with an average operative time of 10 min, and no serious complications, such as cervical spine injury, tongue injury, or tooth loss. All 23 patients were followed up for 3-12 months (average, 6 months) postoperatively. The postoperative course was uneventful and there was no obvious voice hoarseness. Re-examination using a laryngoscope showed smooth edges of the vocal cords, without adhesion and defects, and no polyp recurrence during the follow-up period.

Treatment of vocal polyps with difficult exposure of the glottis is possible with nasal endoscopy and angled-laryngeal forceps.