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Office-Based Injection Laryngoplasty

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Office-Based Laryngeal Surgery

Abstract

Injection laryngoplasty is performed for treatment of vocal fold paralysis/paresis, atrophy, bowing, scar and/or sulcus vocalis, and other causes of glotti

c insufficiency or dysphonia. Recent advances in technology have facilitated the performance of this procedure in an office setting while the patient is awake. The most commonly adopted approaches are the peroral approach; the transcervical approach, via the thyroid cartilage referred to as transthyroid (TT), via the thyrohyoid membrane (TH), or via the cricothyroid membrane (CT); and the transnasal fiberoptic approach using a flexible endoscope with a working channel. The choice of approach depends on the patient’s tolerance and anatomic variations, physician’s expertise, the viscosity and volume of the material to be injected, and the availability of resources. Coincident with the evolution in surgical approaches and techniques, different types of injectate substances have been introduced over the last few decades, each with its advantages and limitations. The main challenges in finding the ideal filling substance are biocompatibility, availability, ease of harvesting, and cost. The choice of injection material also varies with the desired duration of effect. Injection laryngoplasty may be temporary if nerve recovery within 1 year is anticipated or may be long-lasting for patients with transection of the recurrent laryngeal nerve, for example.

This chapter reviews the timing of injection laryngoplasty, as well as the surgical outcomes and complications reported with the use of different substances. The impact of age, gender, and other patient-related factors is stressed.

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Hamdan, Al., Sataloff, R.T., Hawkshaw, M.J. (2022). Office-Based Injection Laryngoplasty. In: Office-Based Laryngeal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-91936-8_8

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