Injection Materials for the Larynx
Glottal insufficiency resulting from vocal fold paralysis (VFP) causes numerous voice complaints, including vocal fatigue, hoarseness, loss of projection, and breathiness. Dysphagia often occurs with VFP and paresis. The most common etiology of VFP is iatrogenic nerve injury. Surgical procedures commonly associated with iatrogenic VFP include thyroidectomy/parathyroidectomy, anterior cervical disc surgery, esophagectomy, thymectomy, neck dissection, carotid endarterectomy, mediastinoscopy, and cardiothoracic surgery, including aortic surgery, coronary artery bypass grafting, and pulmonary lobar resection. Endotracheal intubation, prolonged nasogastric tube placement, and even esophageal stethoscope placement have all been implicated as occasional causes of VFP. 1 , 2 , 3 , 4 , 5 392Various techniques, including laryngeal framework surgery and injection laryngoplasty, have been applied in the management of VFP and resultant glottal insufficiency.