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European Radiology
Published in: European Radiology 5/2012

01-05-2012 | Interventional

Combined ultrasound/endoscopy-assisted vocal fold injection for unilateral vocal cord paralysis: a case series

Authors: Siu Kwan Ng, Hok Yuen Yuen, Charles A. van Hasselt, Anil Ahuja

Published in: European Radiology | Issue 5/2012

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Abstract

Objective

Transcutaneous vocal cord injection is a popular treatment choice for patients suffering from unilateral vocal cord paralysis. Transcutaneous transcartilaginous (through the thyroid cartilage) approach abolishes any anatomical constraint to reach the vocal cord. However it is a largely blind procedure as the needle should stay submucosal. Herein we report our experience in employing ultrasound guidance to circumvent this problem.

Methods

Retrospective review of a series of 8 patients who underwent combined ultrasound/endoscopy-assisted vocal cord injection for unilateral vocal cord paralysis.

Results

Vocal cord injections were successfully completed in all but one patient. There were no associate complications.

Conclusion

The use of ultrasound in aiding transcutaneous transcartilaginous vocal cord injection is safe and feasible.

Key Points

• Vocal cord injection is effective in treating unilateral vocal cord paralysis
• A number of transcutaneous approaches with the patient awake have been described
• Transcutaneous transcartilaginous approach theoretically has minimal anatomical restraint to reach the vocal cord
• Disadvantage of that approach is the difficulty to accurately position the needle
• Our experience of using ultrasound to circumvent this problem is positive
Literature
1.
Seifert A (1916) Perkutane Paraffinjektion zur Beseitigung der Folgen einseitiger Stimmbandlaehmung [in german]. Z Laryngol Rhinol Otol Ihre Grenzgeb 8:233–235
2.
Zeitler DM, Amin MR (2007) The thyrohyoid approach to in-office injection augmentation of the vocal fold. Curr Opin Otolaryngol Head Neck Sur 15:412–416CrossRef
3.
Amin MR (2006) Thyrohyoid approach for vocal fold augmentation. Ann Otol Rhinol Laryngol 115:699–702PubMed
4.
Lee SW, Kim JW, Chung CH et al (2010) Utility of injection laryngoplasty in the management of post-thyroidectomy vocal cord paralysis. Thyroid 20:453–458CrossRef
5.
Tam M, Woo P (2010) Injection laryngoplasty with micronized dermis: a 10-year experience with 381 injections in 344 patients. Laryngoscope 120:2460–2466CrossRef
6.
Sidhu S, Stanton R, Shahidi S, Chu J, Chew S, Campbell P (2001) Initial experience of vocal cord evaluation using grey-scale, realtime, B-mode ultrasound. ANZ J Surg 71:737–739PubMedCrossRef
7.
Friedman EM (1997) Role of ultrasound in the assessment of vocal cord function in infants and children. Ann Otol Rhinol Laryngol 106:199–209PubMed
8.
Vats A, Worley GA, De Bruyn R, Porter H, Albert DM, Bailey CM (2004) Laryngeal ultrasound to assess vocal fold paralysis in children. J Laryngol Otol 108:429–431
Metadata
Title
Combined ultrasound/endoscopy-assisted vocal fold injection for unilateral vocal cord paralysis: a case series
Authors
Siu Kwan Ng
Hok Yuen Yuen
Charles A. van Hasselt
Anil Ahuja
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 5/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2337-6

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