Office‐based injection laryngoplasty in the irradiated larynx

Abstract

Office-based injection laryngoplasty is a safe procedure with acceptable clinical results in patients with vocal fold paralysis who have a history of radiation therapy to the larynx.

Safety of Adult Ambulatory Direct Laryngoscopy

“…Apart from the surgical realm, there is a growing body of literature describing the feasibility and safety of many office-based laryngology procedures, including diagnostics, vocal cord injection, and laser ablation. [1][2][3][4][5][6][7][8][9] In the operating room, direct laryngoscopy practices have benefited from the addition of endoscopic adjuncts, but the fundamental techniques have not changed drastically over the past years. Notably, the perioperative treatment of patients undergoing direct laryngology has experienced a paradigm shift away from reflexive inpatient admission in every case.…”

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

“…However, these approaches involve violation of the airway mucosa, which poses a potential risk of bleeding or patient discomfort during the procedure. The transcutaneous transthyroid cartilage approach has also been developed as an alternative with the advantage of relative anatomical simplicity for submucosally locating the needle to reach the paraglottic space, as compared to the cricothyroid membrane approach [ 99 ]. However, ossification of the thyroid cartilage limits this approach in elderly patients, who constitute the majority of UVFP patients.…”

Laryngeal Framework Surgery in the Irradiated Neck

“…10 Unfortunately, a history of radiation therapy has traditionally been considered a relative contraindication to laryngeal framework surgery due to concerns regarding implant extrusion, chrondronecrosis, and surgical complications. 1,11,12 In the head and neck literature, several studies have documented increased rates of perioperative complications in the setting of salvage surgery following radiotherapy. 13,14 Concerns often include increased surgical difficulty due to fibrosis and obliteration of tissue planes, wound dehiscence, surgical site infection, and the potential for chrondronecrosis or osteoradionecrosis.…”

“…16 Despite widespread concern, the literature regarding management of glottal incompetence and specifically the performance of LFS in the radiated population is limited. 17,18 Kupferman and colleagues 11 have documented promising results with vocal fold injection in irradiated patients. As a major tertiary referral center for head and neck cancer, we see a high volume of patients with laryngeal complaints following surgical or nonsurgical treatment for their cancer.…”