Immediate percutaneous medialization for acute vocal fold immobility with aspiration.
OBJECTIVE
To determine the efficacy of immediate bedside or office percutaneous, trans-thyroidal injections of a bioabsorbable gelatin material (Gelfoam, Upjohn Co., Kalamazoo, MI) to decrease the risk of aspiration resulting from acute vocal fold immobility.


METHODS
Retrospective review of patients presenting with acute vocal fold immobility and aspiration or high aspiration risk at an urban, tertiary care university hospital.


METHODS
All patients were evaluated by videostroboscopy, functional endoscopic evaluation of swallowing (FEES), and objective voice measures. Patients with acute vocal fold immobility and evidence of aspiration on history or FEES were given the option of medialization by Gelfoam injection. Injections were performed percutaneously in the office or at the bedside under laryngoscopic guidance. FEES was repeated after injection to verify improvement in aspiration.


RESULTS
Eleven patients underwent Gelfoam injection for treatment of aspiration and vocal fold immobility. All were significantly improved on post-injection FEES study. All patients were returned to an oral diet, avoiding the need for long-term enteral access.


CONCLUSIONS
Percutaneous Gelfoam injections is a rapid, temporary solution to the common problem of aspiration resulting from acute vocal fold immobility.
Anderson
T D
TD
Department of Otorhinolaryngology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, U.S.A.
Mirza
N
N
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000517:prevention & control*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage / Q000494:pharmacology*; D006490:Hemostatics / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D001239:Inhalation / Q000187:drug effects*; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014826:Vocal Cord Paralysis / Q000150:complications*
D006490:Hemostatics