Injection Laryngoplasty Under Fiberoptic Endoscopy

Efficacy of trans-nasal fiberendoscopic injection laryngoplasty with centrifuged autologous fat in the treatment of glottic insufficiency due to unilateral vocal fold paralysis

“…Its aim is to improve glottic compensation by the contralateral mobile vocal fold 7 . When voice therapy does not provide a positive effect, in particular when the glottic gap is wide because the immobile vocal fold (VF) lies in abducted (lateral) or intermediate position, phonosurgery may be indicated 8 . Several phonosurgical techniques for the treatment of GI due to UVFP have been proposed, which include medialisation laryngoplasty (thyroplasty type I) and/or arythenoid adduction 9 and neurorrhaphy 10 .…”

“…Several phonosurgical techniques for the treatment of GI due to UVFP have been proposed, which include medialisation laryngoplasty (thyroplasty type I) and/or arythenoid adduction 9 and neurorrhaphy 10 . Injection laryngoplasty (IL) is another widely applied phonosurgical technique 8 . IL is a safe and well-established procedure, frequently performed in the early treatment of GI 8 10 .…”

“…In addition, early medialisation IL within 6 months of onset of UVFP may reduce the need of permanent external phonosurgery 6 14 . IL can be performed either under local or general anaesthesia using various alloplastic materials 10 14 or autologous fat 8 . The advantages of the local anaesthesia (LA) are noteworthy.…”

“…In order to overcome these limitations, a phonosurgical approach using a trans-nasal flexible fiberendoscope has been proposed by the CELF group (Cirugia EndoLaringea Fibroscopica) of Santander (Spain) 18 and further developed in Italy 8 19 20 . This phonosurgical technique is also used for the removal of laryngeal polyps, granulomas and papillomas with flexible cold instruments or with fibre lasers [20][21][22] as well as to perform IL 8 ; it was named "fiberendoscopic phonosurgery" (FEPS) 8 19 20 . In particular, regarding IL under FEPS, Ricci-Maccarini et al 8 19 developed a completely transnasal fiberendoscopic IL procedure, using a high-pressure injection pistol connected to a flexible injection needle, injecting centrifuged autologous fat (with modified Coleman technique) 5 8 19 23 24 .…”

Injection laryngoplasty through a transoral approach using the Guedel oral airway

“…In addition, there is a need for an experienced assistant to perform the flexible endoscopy 1 2 . On the other hand, transnasal injection laryngoplasty as described by Ricci Maccarini A et al is a safe procedure with limited discomfort to the patient 3 . Nevertheless, it has limited application in cases of a narrow nasal passage, especially in patients who are on anticoagulants 3 .…”