Influence of gender and injection site on vocal fold augmentation.
OBJECTIVE
To determine the influence of gender and injection site on the amount of injectate needed to medialize an immobile vocal fold, and to describe the distribution patterns of the injected bolus.


METHODS
Surgical intervention in human cadaveric larynges in experimental setting.


METHODS
Cadaveric larynges were injected with calcium hydroxylapatite into the lateral or medial aspect of the vocal fold. High-resolution CT scans were obtained before and after injection.


RESULTS
Males required 50% to 60% more material than females (P = 0.03). For both genders, lateral injections required more than medial injections (P < 0.001). Laterally injected boluses tended to distribute toward the cricothyroid space, with frank extrusions more common in females.


CONCLUSIONS
The amount of injectate required to medialize male and female vocal folds is significantly different. The smaller size of the female larynx likely accounts for a higher incidence of extrusion through the cricothyroid space. These gender differences should be taken into consideration when performing injection laryngoplasty.
Mau
Ted
T
Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA, USA.
Courey
Mark S
MS
D001672:Biocompatible Materials / Q000008:administration & dosage*; D002102:Cadaver; D017886:Durapatite / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections; D007830:Larynx / Q000000981:diagnostic imaging; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods*; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging / Q000601:surgery*; D014827:Vocal Cords
D001672:Biocompatible Materials; D017886:Durapatite