Office-based injection laryngoplasty for the management of unilateral vocal fold paralysis.
OBJECTIVE
Office-based injection laryngoplasty (OBIL) is a common method of addressing glottal insufficiency. This retrospective chart review identifies the demongraphics, laterality, technique, success rate, injectates, and complications of OBIL performed over a 3-year period at a single institution.


METHODS
Retrospective chart review.


METHODS
All OBILs performed for the management of UVFP by the senior author over 3 years (2007-2009) were identified from billing records. The age, gender, laterality, underlying disease process, augmentation material, route of injection, and complications were recorded.


RESULTS
Eighty-two OBILs were attempted on 57 patients. The most common route of access was transoral (85.6%). All OBILs were able to be completed. Injectates used were hyaluronic acid derivatives (57.3%), calcium hydroxyapatite (16%), and Cymmetra (16.5%). Three complications (3.7%) occurred. Thirty percent of patients ultimately elected for thyroplasty or ansa reinnervation, 22% found their condition to self-resolve, 14% died, and 25% were lost to follow-up.


CONCLUSIONS
Using a variety of approaches, OBIL is possible in almost all patients. The single surgeon transoral route using a rigid angled telescope and curved injection needle was the most commonly used approach. Multiple injectates can be used and have good safety records. The final disposition of patients may be variable and warrants further investigation.
University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine School of Medicine, California.
Sunil P
SP
Verma
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: dailey@surgery.wisc.edu.
Seth H
SH
Dailey
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D001672:Biocompatible Materials / Q000008:administration & dosage* / Q000009:adverse effects; D017886:Durapatite / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D007267:Injections; D058753:Laryngoplasty / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
D001672:Biocompatible Materials; D006820:Hyaluronic Acid; D017886:Durapatite
Hoarseness; Laryngeal surgery; Laryngology; Office-based; Procedures; Reinnervation; Surgery; Thyroplasty; Vocal fold paralysis