title: Direct phonoplasty under local anaesthetic.
abstract: OBJECTIVE
  A new technique of direct phonoplasty under local anaesthetic is described.
  
  
  BACKGROUND
  Vocal-fold medialization is an accepted method to improve voice in patients with a paralysed vocal fold. Various materials have been used to inject into the paralysed vocal fold, resulting in medialization of the fold and improved phonation. The two established methods are direct injection under general anaesthetic and transcutaneous injection under local anaesthetic; both have advantages and disadvantages.
  
  
  METHODS
  A Pentax 80K series flexible endoscope is used to directly inject collagen into the paralysed vocal fold via a reusable 23G endoscopic needle under local anaesthetic.
  
  
  CONCLUSIONS
  New technology and innovation have allowed development of the new technique of direct phonoplasty under local anaesthetic. This combines the advantages of transcutaneous injection under local anaesthetic and direct injection under general anaesthetic, without their disadvantages.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Norfolk and Norwich University Hospital, Norwich, UK.
authors.forename: P
authors.initials: P
authors.lastname: Montgomery
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: A
authors.initials: A
authors.lastname: Qayyum
authors.forename: K
authors.initials: K
authors.lastname: Mierzwa
mesh_terms: D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D003094:Collagen / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D007828:Laryngoscopy; D010699:Phonation; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000628:therapy*
chemical_list: D000779:Anesthetics, Local; D003094:Collagen