Current practice in injection augmentation of the vocal folds: Indications, treatment principles, techniques, and complications

• DOI: 10.1002/lary.20737
• Publication Date: 2009-12-08T19:29:54Z
• Authors: Lucian Sulica; Clark A. Rosen; Gregory N. Postma; Blake Simpson; Milan Amin; Mark Courey; Albert Merati
• Keywords: Paresis; Vocal Cord Paralysis; Vocal fold paralysis

Abstract Objectives/Hypothesis: To identify contemporary indications, treatment principles, technique, injection materials, complications, and success rates of vocal fold augmentation. Study Design: Multi‐institutional retrospective review. Methods: Records patients undergoing augmentation at seven university medical centers from July 2007 through June 2008 were reviewed for information regarding diagnosis, unilateral or bilateral injection, route anesthesia, site (office operating room), material used, reason technique selected, technical success. Results: In 12 months, 460 injections performed, 236 (51%) in awake, unsedated patients, 224 (49%) under general anesthesia. Indications included paralysis (248; 54%), paresis (97; 21%), atrophy (68; 15%) scar (47; 10%). Scar was more likely to be treated the room ( P = .000052). awake 112 (47%) performed by transcricothyroid approach, 55 (23%) peroral 49 (21%) transthyrohyoid membrane 20 (8%) transthyroid cartilage approach. Neither rate (99% vs. 97%) nor complication (3% 2%) differed between asleep techniques. The most common materials clinic setting methylcellulose (35%), bovine collagen (28%), calcium hydroxylapatite (26%); these (36%) (35%). Calcium used anesthesia .019). Five‐year data show that use patient rose 11% 43% 2003 2008. Conclusions: Injection remains a safe, effective, clinically practical with high success, whether patient. rapid adoption over past 5 years speaks its clinical utility. Complication are low equivalent those Otolaryngologists continue variety techniques treat range conditions glottic insufficiency. Laryngoscope, 2010