Laryngeal Electromyography-Guided Hyaluronic Acid Vocal Fold Injection for Unilateral Vocal Fold Paralysis—Preliminary Results

Wang, Chen‐Chi; Chang, Ming-Hong; Liu, Shi-An; Liang, Kai‐Li; Wu, Shang‐Heng; Jiang, Rong–San; Huang, Hsin‐Yu; Lai, Hsiu-Chin

doi:10.1016/j.jvoice.2011.04.003

Cited by 28 publications

(23 citation statements)

References 23 publications

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“…None of the 566 operations we performed on patients from 2011 to 2013 had to be abandoned due to activation of the gag reflex. Similarly, vocal fold injection procedures have been attempted in patients in the awake state and using topical anesthesia, by a method in which the injection materials were injected into the vocal folds perorally using a laryngeal injection needle [2]. However, the gag reflex sometimes interferes with this procedure, as well.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery on elderly patients and patients with comorbidities is also possible. Day surgery, performed using topical anesthesia applied to the larynx, with the patient in a state of wakefulness, has been tried by various groups, mainly for intra-vocal fold injection [1][2][3][4][5][6][7]. Injection of fat or collagen has been performed to prevent vocal fold paralysis and atrophy, while injection of botulinum toxin under electromyogram (EMG) control, etc., has been performed to prevent spasmodic dysphonia.…”

Section: Introductionmentioning

confidence: 99%

“…In terms of the approach to the larynx, some surgeons have approached the glottis using percutaneous insertion of an injection needle [2,[4][5][6][7]. For this, the needle is inserted percutaneously via the cricothyroid or thyrohyoid membranes, and injection into the vocal folds is performed when the needle reaches the glottis.…”

Section: Introductionmentioning

confidence: 99%

“…However, since the approach is from the subglottis, direct confirmation of the target site is difficult. Thus, EMG may be required to confirm that the needle has actually reached the thyroarytenoid muscle, which is the target [2]. On the other hand, in the case of the thyrohyoid approach (THA), the surgery can be carried out while observing the needle tip with an endoscope, making this a very useful method.…”

Section: Introductionmentioning

confidence: 99%

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Day surgery for vocal fold lesions using a double-bent 60-mm Cathelin needle

Toyomura

Tokashiki

Hiramatsu

et al. 2014

Eur Arch Otorhinolaryngol

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Day surgery for vocal cord lesions overcomes the disadvantages of laryngomicrosurgery under general anesthesia. We present our experience with treatment of vocal fold lesions using a long double-bend Cathelin needle that can access all parts of the vocal cords. A 23G, 60-mm-long Cathelin needle was bent twice by 45(o) at a distance of 1 and 2 cm from the tip, and was attached to a syringe. Under topical anesthesia and nasal endoscopy of the laryngopharynx, the needle was inserted percutaneously perpendicular to the skin, the direction of insertion being altered when the bends in the needle reached the skin surface. This allows the tip of the needle to access all parts of the glottis, allowing the performance of procedures such as biopsies, excision of lesions, and injection into the vocal folds. Between January 2011 and December 2013, we used this technique to perform vocal fold procedures in 566 patients presenting for treatment of spasmodic dysphonia (412 cases, 73 %) and other vocal fold lesions. Only minor complications, such as hematoma (3 patients, 0.5 %) and slight bleeding from the puncture site in the epiglottic vallecula (all patients, 100 %), which ceased spontaneously within 10 min, were seen. Erroneous puncture occurred in three patients (0.5 %) and the puncture had to be repeated in 38 patients (6.7 %). The procedure was completed successfully in all cases (100 %). Surgery for vocal fold lesions under topical anesthesia using our double-bend Cathelin needle technique is simple, safe, and useful.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Day surgery for vocal fold lesions using a double-bent 60-mm Cathelin needle

Toyomura

Tokashiki

Hiramatsu

et al. 2014

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…The optimal rehabilitation period after UVFP is within one year after surgery, so timely and effective treatment may help patients to restore voice function. Many surgical treatments and voice training methods for UVFP have been reported for those who suffer from UVFP in a paramedian position and if they do not recover within 6 months, another surgery is needed, including intracordal injection, arytenoid adduction, laryngoplasty, transplantation or decompression of the RLN [10][11][12][13][14][15][16][17][18][19]. These surgeries could make the affected VF side move to the midline, promoting glottal closure and improving vocal function.…”

Section: Introductionmentioning

confidence: 99%