Vocal Fold Injections

• Indications: elliptical (bowed) defects, may be used as a temporizing procedure

• Advantages: easy, immediate improvement, may be completed in the office (although most often managed in the operating room under local or general anesthesia)

• Disadvantages: irreversible if Teflon used, changes mucosal wave, does not correct large posterior defects, contraindicated if vocal folds are not at the same level

• Complications: granuloma formation (with superficial injections or migration of Teflon), under- or over-injection (risk of airway compromise), acute hypersensitivity

• Injection Materials

1. Gelfoam: indicated if recovery is expected (neurapraxia), 30% overcorrection to compensate for saline resorption, effective for 4—6 weeks

2. Fat: effective for 6 months (or longer), no foreign body reaction, up to 50% resorption after 6 months, 40% overcorrection to compensate for resorption

3. Collagen: autologous or bovine collagen (risk of host reaction), effective for up to 3 years, collagen eventually is resorbed and replaced with host tissue

4. Teflon Paste (tetrafluoroethylene): largely been replaced due to risk of granuloma formation with superficial injection, risk of migration, stiffening of the mucosal wave, and difficulty with removal

Was this article helpful?

0 0

Post a comment