title: Bedside Injection Medialization Laryngoplasty in Immediate Postoperative Patients.
abstract: OBJECTIVE
  The morbidity of glottic insufficiency resulting from unilateral vocal fold immobility may significantly compromise postoperative recovery in patients with decreased pulmonary reserve or inability to protect their airway. Injection medialization laryngoplasty is an effective means of treating glottic insufficiency due to unilateral vocal fold immobility. The purpose of this study is to present our experience with bedside transoral injection medialization laryngoplasty in the immediate postoperative period.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Academic tertiary care hospital.
  
  
  METHODS
  Patient demographics, clinical characteristics, procedural details, and short-term outcome measures of oral intake were recorded in a cohort of 68 patients over 5 years with unilateral vocal cord paralysis who underwent injection medialization as a bedside procedure in the immediate postoperative period.
  
  
  RESULTS
  Mean time to injection was 8.2 days postoperatively. At the time of injection, 40 of 68 patients were nil per os. Seventy percent (28 of 40) had their diet advanced to adequate oral intake within 5 days of injection. Greater than half of the injections (36 of 68) were performed in the intensive care unit. No complications were noted, and all patients in this cohort were able to tolerate the bedside injection.
  
  
  CONCLUSIONS
  Bedside injection medialization laryngoplasty in the immediate postoperative period via the transoral approach can be performed in patients, even in the intensive care unit, while on anticoagulation, and may be of benefit for hospitalized patients with unilateral vocal fold immobility. Further studies quantifying improvement in voice and swallowing data are merited.
authors: Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA Barbu.Anca@mgh.harvard.edu.
authors: Anca M
authors: AM
authors: Barbu
authors: Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: John P
authors: JP
authors: Gniady
authors: Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Richard J
authors: RJ
authors: Vivero
authors: NorthShore University HealthSystem Department of Surgery, Evanston, Illinois, USA.
authors: Aaron D
authors: AD
authors: Friedman
authors: Department of Surgery-Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation-Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: James A
authors: JA
authors: Burns
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004435:Eating; D005260:Female; D006801:Humans; D058753:Laryngoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011184:Postoperative Period; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery
keywords: injection medialization; larynx/surgery; vocal fold paralysis