title: Safety and cost-effectiveness of intra-office flexible videolaryngoscopy with transoral vocal fold injection in dysphagic patients.
abstract: METHODS
  A tertiary care referral-based otolaryngology practice.
  
  
  OBJECTIVE
  To evaluate the safety of office-based transoral oral vocal fold injection in an ambulatory dysphagic population and to evaluate cost-effectiveness in comparison with traditional injection laryngoplasty done under general anesthesia in the operating room. Dysphagia is a nonspecific and common symptom of many head and neck and systemic disease processes. In patients with glottal incompetence, the presenting complaint of dysphagia generally portends to more global oropharyngeal dysfunction than dysphonia alone. Although many authors have reported on and advocated the use of office injection technique in the management of dysphonia caused by glottal insufficiency, there is a paucity of literature regarding the use of this technique in a more medically compromised dysphagic patient population (Ann Otol Rhinol Laryngol 1997;106:778-83). We describe our experience with vocal fold injection in the office setting using a transoral technique under flexible videolaryngoscopy for the treatment of glottal insufficiency in dysphagic patients. The safety and cost-effectiveness of this approach are highlighted.
authors.affiliation: Department of Otolaryngology, Eye and Ear Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Andrade Filho
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Carrau
authors.forename: Robert A
authors.initials: RA
authors.lastname: Buckmire
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000379:methods; D000768:Anesthesia, General / Q000191:economics; D000772:Anesthesia, Local / Q000191:economics; D001037:Aphasia / Q000191:economics / Q000628:therapy*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D005931:Glottis / Q000503:physiopathology*; D006801:Humans; D007267:Injections; D007828:Laryngoscopy / Q000191:economics* / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000191:economics; D009873:Operating Rooms / Q000191:economics; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D014743:Videotape Recording; D014827:Vocal Cords / Q000601:surgery