Look Who’s Talking Again

Surgical procedure alleviates vocal cord paralysis.

Watching the world’s largest animal migration through the plains of the Serengeti, visiting Mount Kilimanjaro and going on safari near the Ngorongoro crater, all in the East African country of Tanzania, are experiences near the top of several bucket lists.

Jabir Chatoo knocked them all off before he even had a bucket list.

“I grew up in Tanzania and am fortunate enough to have visited Mount Kilimanjaro and all the game parks there,” Jabir explains. “I moved to the United States when I was 18, mostly because I wanted my children to have a more meaningful life.”

Jabir has certainly had a meaningful life. Now 60, he owns a successful online company that specializes in selling electronics components and computer parts to individuals and businesses around the world.

Jabir Chatoo

Jabir Chatoo

He started the business about 10 years ago, and it was going extremely well until a few months ago when he woke up from surgery to clear his left carotid artery and could only speak in a whisper.

“The surgery went fine but I was very hoarse afterward, and it was like air was coming out with the words I spoke,” Jabir elaborates. “The doctor thought he scratched my vocal cord when he pulled out the anesthesia tube and said I’d be fine in about six weeks.”

Except that time passed and Jabir still struggled to speak above a whisper and was out of breath after a few words. That prompted a return trip to the surgeon, who recommended he visit Atlantic Ear, Nose & Throat.

Life-Changing Problem

At Atlantic Ear, Nose & Throat, Jabir was examined by Devang M. Shah, MD. Upon hearing about Jabir’s surgery, Dr. Shah knew from experience what was causing Jabir’s hoarseness, but to confirm his belief, he performed a videostroboscopy.

A state-of-the-art probe that provides a magnified, slow-motion view of the vocal cords in action, the videostroboscopy showed that the vocal cord on the side of Jabir’s throat where he had the surgery was paralyzed, just as Dr. Shah feared.

“The vocal cords are like a musical instrument with two reeds, one on each side of the voice box, that vibrate against each other to produce sound,” Dr. Shah educates. “You need both reeds functioning to make the sound. When one is paralyzed or doesn’t connect well, there are problems.

“One problem is that the voice becomes very breathy. Another is that air escapes very quickly as you speak so you’re unable to speak long sentences. The third has to do with another function of the vocal cords, which is the role it plays in swallowing.

“When we swallow food or especially liquid, the vocal cords close tightly to prevent that food or liquid from ending up in the lungs. But if the vocal cords don’t close properly, liquid, in particular, can drip through the gap, causing aspiration. So this is a life-changing problem.”

It certainly changed Jabir’s life. Though he didn’t have much trouble swallowing, he had a hard time communicating. As a result, he had to conduct most of his business ventures via text and email, which greatly slowed the process.

“It was quite challenging because I’m on the phone communicating with people a lot in my business, and when I had this problem, they couldn’t hear me or understand me,” he groused. “It was very frustrating and difficult to do business.”

Thankfully, Dr. Shah had a solution: a surgical procedure, called vocal cord medialization, in which the paralyzed vocal cord is pushed closer to its opposite twin. By doing that, the two vocal cords can once again work in concert with each other and produce a louder, more natural sound.

The procedure is performed through an incision in the neck, where a hole is cut in the voice box. A half-inch-long, triangular-shaped implant is then attached to the paralyzed vocal cord and repositions it.

“The part of the surgery where we place the implant is done while the patient is awake,” Dr. Shah informs. “That’s because we have different-sized implants and we need the patient to speak to us during the operation to be sure we’re placing the right-sized implant.

“We simply ask the patient to count to three, and when the voice comes out strong, we know we’ve got the right implant and it’s positioned properly. It’s a very gratifying procedure because we see the impact right away.”

Dr. Shah predicted the medialization procedure would significantly improve Jabir’s ability to speak, and Jabir experienced just such an improvement.

“After the surgery, I received about 20 or 30 phone calls from friends, and they were all telling me that the difference in my voice was like night and day,” Jabir exudes. “They couldn’t believe what had happened.

“Even the nurse at Atlantic Ear, Nose & Throat who scheduled my follow-up visit with Dr. Shah was amazed at the difference. When I called to make the appointment, she said, I can’t believe that’s you, Mr. Chatoo. It’s a complete transformation.”

Like a Miracle

From the time he came out of the carotid artery surgery to the time of his vocal cord procedure, Jabir waited five months for that transformation. He says he “never expected a miracle” but feels he was the recipient of one nevertheless.

“It’s really unbelievable what Dr. Shah did for me,” he enthuses. “At first, when friends heard me speak, they couldn’t believe it and wanted to know, Who did the surgery? All of a sudden, I was forwarding Dr. Shah’s name and number to everyone.

“I’m very, very grateful for all that Dr. Shah did for me. He’s very meticulous and explained everything about the surgery and what I needed to do afterward so there were no surprises at all, which I greatly appreciated.

“I’ve been through a lot of surgeries and I don’t like surprises. In this case, everything was well articulated to me by Dr. Shah regarding what they were going to do and what the results would be postsurgery. He did a great job.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz.js
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    • Atlantic Ear, Nose and Throat, P.A.

      Atlantic Ear, Nose & Throat is a comprehensive, full-service otolaryngology practice with offices in both Seminole and Volusia counties. In the practice, Devang Shah, MD, and Daniel Rothbaum, MD, combine surgical excellence with a compassion... Read More

    • Devang Shah, MD

      Devang M. Shah, MD, is board-certified in otolaryngology. Dr. Shah attended MIT as an undergraduate. After receiving his medical degree with honors, he completed his surgical internship and residency at Johns Hopkins Hospital in Baltimore. Dr.... Read More

    • Daniel Rothbaum, MD

      Daniel L. Rothbaum, MD, is board-certified in otolaryngology. Dr. Rothbaum graduated magna cum laude from Harvard University and earned his medical degree at the Yale School of Medicine. He completed his internship and residency training at Joh... Read More