Direct phonoplasty under local anaesthetic

Abstract

New technology and innovation have allowed development of the new technique of direct phonoplasty under local anaesthetic. This combines the advantages of transcutaneous injection under local anaesthetic and direct injection under general anaesthetic, without their disadvantages.

Early results for treatment of unilateral vocal fold palsy with injection medialisation under local anaesthetic

“…2 -4,9 -11 Rigid endoscopy also introduces the risk of dental damage and mucosal abrasion or perforation. 1 The procedure can be performed on an out-patient basis, and the patient can provide feedback by phonating on demand. 1 The procedure can be performed on an out-patient basis, and the patient can provide feedback by phonating on demand.…”

“…1 We used a 5.1 mm diameter transnasal flexible laryngoesophagoscope with a 2.2 mm diameter operating channel incorporating a high resolution charge-coupled device chip in its tip, connected to a standard endoscope stack and monitor. 1 We used a 5.1 mm diameter transnasal flexible laryngoesophagoscope with a 2.2 mm diameter operating channel incorporating a high resolution charge-coupled device chip in its tip, connected to a standard endoscope stack and monitor.…”

“…1 The collagen was injected under direct vision into the superior surface of the vocal fold until it lay in the desired position. We injected Zyplast collagen (bovine dermal collagen; Zyplast w , McGhan Medical Corporation, Fremont, CA, USA) which is lightly crosslinked with glutaraldehyde and dispersed in phosphate-buffered saline containing 0.3 per cent lignocaine.…”

“…1 Treatment of vocal fold palsy is aimed at medialising the paralysed fold in order to improve phonation and subsequent quality of life. The resulting dysphonia is characterised by a breathy, asthenic voice, and the palsy may contribute to dysphagia if the vocal folds are widely abducted or there is a degree of associated sensory loss within the larynx.…”

“…1 Treatment of vocal fold palsy is aimed at medialising the paralysed fold in order to improve phonation and subsequent quality of life. 1 Here, we present our experience and results for the first five patients undergoing this procedure. 2 -4 Within our department, we have developed a technique allowing internal injection medialisation of a vocal fold under local anaesthetic using the transnasal flexible laryngoesophagoscope.…”