Tags

Type your tag names separated by a space and hit enter

Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications.
Laryngoscope. 2010 Feb; 120(2):319-25.L

Abstract

OBJECTIVES/HYPOTHESIS

To identify contemporary indications, treatment principles, technique, injection materials, complications, and success rates of vocal fold injection augmentation.

STUDY DESIGN

Multi-institutional retrospective review.

METHODS

Records of patients undergoing injection augmentation at seven university medical centers from July 2007 through June 2008 were reviewed for information regarding diagnosis, unilateral or bilateral injection, route of injection, anesthesia, treatment site (office or operating room), material used, reason for technique selected, and technical success.

RESULTS

In 12 months, 460 injections were performed, 236 (51%) in awake, unsedated patients, and 224 (49%) under general anesthesia. Indications included vocal fold paralysis (248; 54%), paresis (97; 21%), atrophy (68; 15%) and scar (47; 10%). Scar was more likely to be treated in the operating room (P = .000052). In awake patients, 112 (47%) injections were performed by transcricothyroid approach, 55 (23%) by peroral approach, 49 (21%) by transthyrohyoid membrane approach, and 20 (8%) by transthyroid cartilage approach. Neither technical success rate (99% vs. 97%) nor complication rate (3% vs. 2%) differed between awake and asleep techniques. The most common materials in the clinic setting were methylcellulose (35%), bovine collagen (28%), and calcium hydroxylapatite (26%); in the operating room these were calcium hydroxylapatite (36%) and methylcellulose (35%). Calcium hydroxylapatite was more likely to be used under general anesthesia (P = .019). Five-year data show that the use of injection in the awake patient rose from 11% to 43% from 2003 to 2008.

CONCLUSIONS

Injection augmentation remains a safe, effective, and clinically practical treatment with a high rate of success, whether performed in the awake or asleep patient. The rapid adoption of awake injection over the past 5 years speaks to its clinical utility. Complication rates are low and equivalent to those under general anesthesia. Otolaryngologists continue to use a variety of techniques and materials to treat a range of conditions of glottic insufficiency.

Authors+Show Affiliations

Department of Otorhinolaryngology, Weill Cornell Medical College, New York, New York 10021, USA. lus2005@med.cornell.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19998419

Citation

Sulica, Lucian, et al. "Current Practice in Injection Augmentation of the Vocal Folds: Indications, Treatment Principles, Techniques, and Complications." The Laryngoscope, vol. 120, no. 2, 2010, pp. 319-25.
Sulica L, Rosen CA, Postma GN, et al. Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications. Laryngoscope. 2010;120(2):319-25.
Sulica, L., Rosen, C. A., Postma, G. N., Simpson, B., Amin, M., Courey, M., & Merati, A. (2010). Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications. The Laryngoscope, 120(2), 319-25. https://doi.org/10.1002/lary.20737
Sulica L, et al. Current Practice in Injection Augmentation of the Vocal Folds: Indications, Treatment Principles, Techniques, and Complications. Laryngoscope. 2010;120(2):319-25. PubMed PMID: 19998419.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications. AU - Sulica,Lucian, AU - Rosen,Clark A, AU - Postma,Gregory N, AU - Simpson,Blake, AU - Amin,Milan, AU - Courey,Mark, AU - Merati,Albert, PY - 2009/12/10/entrez PY - 2009/12/10/pubmed PY - 2010/2/17/medline SP - 319 EP - 25 JF - The Laryngoscope JO - Laryngoscope VL - 120 IS - 2 N2 - OBJECTIVES/HYPOTHESIS: To identify contemporary indications, treatment principles, technique, injection materials, complications, and success rates of vocal fold injection augmentation. STUDY DESIGN: Multi-institutional retrospective review. METHODS: Records of patients undergoing injection augmentation at seven university medical centers from July 2007 through June 2008 were reviewed for information regarding diagnosis, unilateral or bilateral injection, route of injection, anesthesia, treatment site (office or operating room), material used, reason for technique selected, and technical success. RESULTS: In 12 months, 460 injections were performed, 236 (51%) in awake, unsedated patients, and 224 (49%) under general anesthesia. Indications included vocal fold paralysis (248; 54%), paresis (97; 21%), atrophy (68; 15%) and scar (47; 10%). Scar was more likely to be treated in the operating room (P = .000052). In awake patients, 112 (47%) injections were performed by transcricothyroid approach, 55 (23%) by peroral approach, 49 (21%) by transthyrohyoid membrane approach, and 20 (8%) by transthyroid cartilage approach. Neither technical success rate (99% vs. 97%) nor complication rate (3% vs. 2%) differed between awake and asleep techniques. The most common materials in the clinic setting were methylcellulose (35%), bovine collagen (28%), and calcium hydroxylapatite (26%); in the operating room these were calcium hydroxylapatite (36%) and methylcellulose (35%). Calcium hydroxylapatite was more likely to be used under general anesthesia (P = .019). Five-year data show that the use of injection in the awake patient rose from 11% to 43% from 2003 to 2008. CONCLUSIONS: Injection augmentation remains a safe, effective, and clinically practical treatment with a high rate of success, whether performed in the awake or asleep patient. The rapid adoption of awake injection over the past 5 years speaks to its clinical utility. Complication rates are low and equivalent to those under general anesthesia. Otolaryngologists continue to use a variety of techniques and materials to treat a range of conditions of glottic insufficiency. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/19998419/Current_practice_in_injection_augmentation_of_the_vocal_folds:_indications_treatment_principles_techniques_and_complications_ L2 - https://doi.org/10.1002/lary.20737 DB - PRIME DP - Unbound Medicine ER -