Development of a device for real‐time light‐guided vocal fold injection: A preliminary report

Cha, Wonjae; Ro, Jung Hoon; Wang, Soo-Geun; Jang, Jeon Yeob; Cho, Jae Keun; Kim, Geun‐Hyo; Lee, Yeon Woo

doi:10.1002/lary.25661

Cited by 10 publications

(44 citation statements)

References 14 publications

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“…Thus, we postulated that a new concept (RL‐VFI) requires two features to overcome the shortcomings of the CT approach and improve its practicality: 1) the needle tip should be visible to allow identification of its precise location, and 2) the injectate should be instilled simultaneously without manipulation. We then developed a concept model satisfying these necessities and demonstrated its technical feasibility in the previous pilot study …”

Section: Discussionmentioning

confidence: 99%

“…The corresponding author ( w.c. ) also had difficulties mastering the CT approach, which motivated conceptualization of a new technique that allows simultaneous VFI under light guidance: real‐time light‐guided VFI (RL‐VFI). In a previous study, the concept model to implement RL‐VFI was developed and its technical feasibility was validated . In the present study, we aimed to verify the feasibility of the new technique in a cadaveric canine model, simulating the setting of office‐based VFI, and to explore its clinical usefulness.…”

Section: Introductionmentioning

confidence: 96%

“…Each approach has its advantages and disadvantages. The choice of approach usually depends on the surgeon's preference, the injection material, and the condition of the patient . The transoral approach is straightforward and easy to learn because the needle tip is clearly visualized under endoscopy.…”

Section: Introductionmentioning

confidence: 99%

“…This modified approach may significantly reduce the risk of bleeding, laryngospasm, and injectate spillage. It also has accelerated the spread of office‐based VFI . Currently, some laryngologists favor the CT approach because the submucosal pathway has several advantages: a low complication rate, suitability as an office‐based procedure, and good patient compliance .…”

Section: Introductionmentioning

confidence: 99%

“…Currently, some laryngologists favor the CT approach because the submucosal pathway has several advantages: a low complication rate, suitability as an office‐based procedure, and good patient compliance . However, despite these advantages, this approach has the inevitable limitation that precise localization of the needle tip is difficult because it utilizes the submucosal route . To overcome this problem, most laryngologists have used physical maneuvers such as CT membrane palpation and the distortion feature of the vocal fold, as well as anatomical references .…”

Section: Introductionmentioning

confidence: 99%

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Real‐Time Light‐Guided Vocal Fold Injection: Ex Vivo Feasibility Study in a Canine Model

Cha¹,

Yang

et al. 2018

The Laryngoscope

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Objective The transcricothyroid (CT) membrane approach is a good option for office‐based vocal fold injection (VFI). However, because the needle tip is invisible during injection using the CT approach, precise localization requires a high level of experience, and mastering this approach involves a steep learning curve. To overcome current limitations, we conceptualized a novel technique: real‐time light‐guided VFI (RL‐VFI), which enables simultaneous VFI under direct visualization of the lighted needle tip. Herein, we aimed to verify the feasibility of RL‐VFI in cadaveric canine model, simulating the setting of office‐based VFI, as well as to explore its clinical usefulness. Study Design Animal study. Methods A customized prototype device was developed. It consisted of three parts: light source, controller, and injector. Light source comprised laser diodes of two wavelengths (635 nanometers [nm], red; 532 nm, green). Four types of injector were developed using 40‐mm needles of 23‐ and 25‐gauge and optic fibers of 50 and 100 μm. ex vivo canine larynx was prepared for the experiment. Flexible laryngoscopy system was used to examine canine vocal folds. Results Various routes from three insertion points (3 mm, 10 mm, and 17 mm from the midline) were validated using the device. Regardless of the injection routes, the location of the needle tip was accurately indicated by light. RL‐VFI was feasible under light guidance without difficulties. Moreover, precise and simultaneous re‐injection could be performed at the intended point using the device. Conclusion We introduced RL‐VFI using our customized prototype device in an ex vivo canine larynx, simulating the setting of office‐based VFI. Clinical application of RL‐VFI will improve safety and precision of CT approach, as well as expand its applications in laryngology. Level of Evidence NA. Laryngoscope, 129:935–942, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%