title: Efficacy and safety of acute injection laryngoplasty for vocal cord paralysis following thoracic surgery.
abstract: OBJECTIVE
  The primary objective of this study was to evaluate the effectiveness and safety of injection laryngoplasty using a temporary injectable agent in the acute setting for patients with unilateral vocal cord paralysis following thoracic surgical procedures.
  
  
  METHODS
  Retrospective consecutive case series in an academic institution.
  
  
  METHODS
  Inclusion criteria included patients acutely treated with injection laryngoplasty from January 1, 2006, to March 31, 2010, for a unilateral vocal cord paralysis that occurred after a thoracic surgical procedure (N = 20). All patients were injected with Radiesse Voice Gel using microlaryngoscopy technique.
  
  
  RESULTS
  The mean time to vocal cord injection from the time of thoracic surgery was 4.5 days. There was one operative-related complication of intraoperative bile reflux that caused a pneumonitis. Ninety percent of patients were recommended for strict nothing by mouth prior to injection. Of these, 94% were allowed an oral diet following injection, and 67% tolerated a regular diet. None of the patients required subsequent procedures for aspiration or dysphagia, and 25% required further intervention after discharge for persistent dysphonia. Patients with a known nerve transection had a higher rate of dysphonia requiring further surgical procedures than those who did not have a known nerve transection.
  
  
  CONCLUSIONS
  Acute treatment of thoracic surgery-related unilateral vocal cord paralysis with injection laryngoplasty appears safe and effective at preventing postoperative aspiration pneumonia and improves swallowing function to allow resumption of an oral diet. A single injection is often the only required treatment.
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors: Evan M
authors: EM
authors: Graboyes
authors: Joseph P
authors: JP
authors: Bradley
authors: Bryan F
authors: BF
authors: Meyers
authors: Brian
authors: B
authors: Nussenbaum
mesh_terms: D000328:Adult; D000368:Aged; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage*; D016629:Esophagectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007267:Injections; D058753:Laryngoplasty / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D055815:Young Adult
chemical_list: D002266:Carboxymethylcellulose Sodium