The usefulness of the transcricothyroid injection laryngoplasty via contralateral paramedian approach.
OBJECTIVE
Several laryngeal injection techniques are technically difficult and have limitations. In this study, we modified a transcricothyroid approach for injections to enhance needle visualization during procedures. The objective of this study was to investigate the efficacy of this alternative injection technique.


METHODS
We performed a retrospective analysis of 51 patients who had undergone injection laryngoplasty for unilateral vocal paralysis between March 2014 and February 2015. In total, 17 patients underwent a transcricothyroid injection laryngoplasty via the contralateral paramedian approach (ILC) and 34 patients underwent transcricothyroid injection laryngoplasty via the conventional approach (ipsilateral approach, ILI). Acoustic analyses, aerodynamic analyses, voice handicap index (VHI), and GRBAS scale were assessed pre-operatively and at 2 weeks and 3 months postoperatively.


RESULTS
From our acoustic and aerodynamic analyses, jitter, shimmer, noise-to-harmonic ratio (NHR), maximum phonation time (MPT), and mean flow rate (MFR) were all significantly improved in both groups after injection. VHI and GRBAS scales also improved postoperation. There were no significant differences between the pre-operative and postoperative subjective and objective parameters between both groups. The total injection volume used on the ILI group was larger than the volume given to the ILC group.


CONCLUSIONS
The transcricothyroid injection laryngoplasty via the contralateral paramedian approach is potentially more beneficial to performing injection laryngoplasty under local anesthesia. One important advantage of this approach to conventional approaches is its enhanced visualization of the needle during procedures.
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Seonam University of Korea, Myong-ji Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
Byung-Joon
BJ
Chun
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Mi-Ran
MR
Shim
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Yeon-Shin
YS
Hwang
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Young-Hoon
YH
Joo
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Young-Hak
YH
Park
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: hnsdi@catholic.ac.kr.
Dong-Il
DI
Sun
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods*; D058753:Laryngoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010699:Phonation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality
Cricothyroid approach; Injection laryngoplasty; Office-based; Vocal cord palsy