Materials for Injection Laryngoplasty: Current Application

Trebbi, Marco; Villari, Domenico; Ruberto, Marco

doi:10.1007/978-3-319-20143-6_4

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…2,5 Various materials and techniques are available for injection laryngoplasty in the clinic and operating room. 6 Material and approach selection are based on the etiology of glottal insufficiency, patient anatomy, patient and surgeon preference, and the patient's ability to tolerate inoffice procedures. 1,2 Commonly used injectables include carboxymethylcellulose (CMC), hyaluronic acid (HA), and calcium hydroxylapatite (CaHa).…”

Section: Introductionmentioning

confidence: 99%

Quantification of injection force mechanics during injection laryngoplasty

Pearson

Ortiz²,

Montelongo

et al. 2018

The Laryngoscope

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Objectives In‐office or operative injection laryngoplasty requires needle stability for accurate material placement. To date, no reports compare injection forces based on needle gauge, bends, length, or material type or temperature. We hypothesize these factors alter injection forces and could impact clinical use. Methods Swine larynges were placed in a compression testing machine. Syringes were affixed to a stabilizing crossbeam. Straight needles (25G 1.5‐inch; 27G 1.25‐inch; or 9.8‐inch malleable shaft 16G per oral with 24G tapered needle tip) were inserted into the swine vocal folds to simulate realistic tissue resistance pressure. Compressive loading was conducted at 40 mm/minute until steady‐state force was achieved. Tests were completed with calcium hydroxylapatite (CaHa), carboxymethylcellulose, and hyaluronic acid at various temperatures and CaHa with various bends in the needles (n = 3 per group, comparisons performed by two‐way analysis of variance (ANOVA), Tukey's post‐hoc). Results Needle size, shape, and temperature altered injection force. Steady‐state force was highest with the per‐oral needle at a mean of 44.55N compared to 26.44N and 29.77N in the 25G and 27G percutaneous needles, respectively (P < 0.001). Stiffness rate (initial increasing force vs. distance to initiate injection) ranged from 19.75N/mm (per oral) to 22.06N/mm (25G) to 24.56N/mm (27G), (P = 0.875). Adding multiple bends to the per‐oral needle increased stiffness rate to 24.99N/mm (P = 0.035), whereas the 25G needle stiffness rate remained unchanged (P = 0.941), with the stiffness rate decreasing in the 27G needle with increasing bends (P = 0.033). Increased temperature decreased injection forces across all materials. Conclusion Needle caliber, length, and bends impact steady‐state forces and stiffness rates during vocal fold injection. Level of Evidence NA Laryngoscope, 129:1060–1066, 2019

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