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Evaluating Safety of Awake, Bilateral Injection Laryngoplasty for Bilateral Vocal Fold Atrophy.
J Voice. 2020 Mar 07 [Online ahead of print]JV

Abstract

OBJECTIVE

Office-based injection laryngoplasty (IL) has emerged as a useful procedure for otolaryngologists to correct glottic insufficiency while avoiding the costs and risks of general anesthesia. This is the first study focused on addressing the safety of bilateral IL for bilateral vocal fold (VF) atrophy.

METHODS

Patient records were reviewed from Emory University Hospital Midtown during the period of 2005 to 2017. Patients who underwent awake, bilateral transthyrohyoid, transoral, transcricothyroid, or transthyroid cartilage IL for bilateral VF atrophy were analyzed. All procedures, including repeat injections, were bilateral. Complication rate was used to evaluate safety. Patients with vocal cord paralysis, paresis, scar, and sulcus were excluded from the study.

RESULTS

Total 174 procedures met inclusion criteria. There were four complications, yielding a complication rate of 2.3%. Complications included aborted cases for difficult anatomy or poor patient tolerance, injection material not resorbing, and a VF hematoma. No patients had any airway emergencies or required admission to the hospital or evaluation in the emergency room.

CONCLUSIONS

This study illustrates a low complication rate for awake, bilateral IL in treating bilateral VF atrophy. This supports other studies that promote the safety of this procedure in the awake setting. Complications were associated with patient tolerance, unique anatomy, and in one case, anticoagulant medication. The low complication rate supports the conclusion that bilateral medialization IL is safe to perform in the office-based, awake setting.

Authors+Show Affiliations

Emory University School of Medicine, Atlanta, Georgia.Department of Otolaryngology-Head and Neck Surgery, Emory Voice Center, Emory University School of Medicine, Atlanta, Georgia.Department of Otolaryngology-Head and Neck Surgery, Emory Voice Center, Emory University School of Medicine, Atlanta, Georgia. Electronic address: adam.klein@emory.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32156451

Citation

Kelly, Zachary, et al. "Evaluating Safety of Awake, Bilateral Injection Laryngoplasty for Bilateral Vocal Fold Atrophy." Journal of Voice : Official Journal of the Voice Foundation, 2020.
Kelly Z, Patel AK, Klein AM. Evaluating Safety of Awake, Bilateral Injection Laryngoplasty for Bilateral Vocal Fold Atrophy. J Voice. 2020.
Kelly, Z., Patel, A. K., & Klein, A. M. (2020). Evaluating Safety of Awake, Bilateral Injection Laryngoplasty for Bilateral Vocal Fold Atrophy. Journal of Voice : Official Journal of the Voice Foundation. https://doi.org/10.1016/j.jvoice.2020.01.005
Kelly Z, Patel AK, Klein AM. Evaluating Safety of Awake, Bilateral Injection Laryngoplasty for Bilateral Vocal Fold Atrophy. J Voice. 2020 Mar 7; PubMed PMID: 32156451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating Safety of Awake, Bilateral Injection Laryngoplasty for Bilateral Vocal Fold Atrophy. AU - Kelly,Zachary, AU - Patel,Anju K, AU - Klein,Adam M, Y1 - 2020/03/07/ PY - 2019/10/14/received PY - 2020/01/07/revised PY - 2020/01/08/accepted PY - 2020/3/12/entrez KW - Bilateral injection KW - Laryngology KW - Laryngoplasty, Presbylaryngis KW - Office procedure KW - Vocal fold atrophy JF - Journal of voice : official journal of the Voice Foundation JO - J Voice N2 - OBJECTIVE: Office-based injection laryngoplasty (IL) has emerged as a useful procedure for otolaryngologists to correct glottic insufficiency while avoiding the costs and risks of general anesthesia. This is the first study focused on addressing the safety of bilateral IL for bilateral vocal fold (VF) atrophy. METHODS: Patient records were reviewed from Emory University Hospital Midtown during the period of 2005 to 2017. Patients who underwent awake, bilateral transthyrohyoid, transoral, transcricothyroid, or transthyroid cartilage IL for bilateral VF atrophy were analyzed. All procedures, including repeat injections, were bilateral. Complication rate was used to evaluate safety. Patients with vocal cord paralysis, paresis, scar, and sulcus were excluded from the study. RESULTS: Total 174 procedures met inclusion criteria. There were four complications, yielding a complication rate of 2.3%. Complications included aborted cases for difficult anatomy or poor patient tolerance, injection material not resorbing, and a VF hematoma. No patients had any airway emergencies or required admission to the hospital or evaluation in the emergency room. CONCLUSIONS: This study illustrates a low complication rate for awake, bilateral IL in treating bilateral VF atrophy. This supports other studies that promote the safety of this procedure in the awake setting. Complications were associated with patient tolerance, unique anatomy, and in one case, anticoagulant medication. The low complication rate supports the conclusion that bilateral medialization IL is safe to perform in the office-based, awake setting. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/32156451/Evaluating_Safety_of_Awake,_Bilateral_Injection_Laryngoplasty_for_Bilateral_Vocal_Fold_Atrophy L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(19)30349-2 DB - PRIME DP - Unbound Medicine ER -
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