Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-02T23:12:20.007Z Has data issue: false hasContentIssue false

Early results for treatment of unilateral vocal fold palsy with injection medialisation under local anaesthetic

Published online by Cambridge University Press:  07 April 2017

R Pratap*
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital, UK
P Mehta
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital, UK
B Blagnys
Affiliation:
Department of Speech and Language Therapy, Norfolk and Norwich University Hospital, UK
P Q Montgomery
Affiliation:
Department of Otolaryngology, Norfolk and Norwich University Hospital, UK
*
Address for correspondence: Mr Rohit Pratap, Department of Otolaryngology, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK. Fax: 07092 010618 E-mail: [email protected]

Abstract

Background:

The diagnosis and treatment of unilateral vocal fold palsy is a common part of otolaryngology practice. In those patients in whom resolution of symptoms is slow, the resulting dysphonia can have a dramatic effect on the patient's quality of voice and life. We have previously described the procedure of direct phonoplasty under local anaesthesia using the transnasal laryngoesophagoscope.

Objective:

To examine the subjective and objective data for the first five patients to undergo this procedure, in the form of laryngographic speech analysis, perceptual assessment and therapy outcome measures.

Results:

Analysis showed a statistically significant improvement in voice quality, in all the above assessment categories, following local anaesthetic direct phonoplasty using the transnasal laryngoesophagoscope.

Conclusion:

Collagen injection via transnasal flexible laryngoesophagoscopy is a particularly useful technique for treating vocal fold medialisation, especially in palliative care patients and those with shortened life expectancy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Montgomery, P, Sharma, A, Qayyum, A, Mierzwa, K. Direct phonoplasty under local anaesthetic. J Laryngol Otol 2005;119:134–7CrossRefGoogle ScholarPubMed
2 Sato, K, Umeno, H, Nakashima, T. Autologous fat injection laryngohypopharyngoplasty for aspiration after vocal cord paralysis. Ann Otol Rhinol Laryngol 2004;113:8792CrossRefGoogle Scholar
3 Havas, TE, Priestly, KJ. Autologous fat injection laryngoplasty for unilateral vocal cord paralysis. Aust N Z J Surg 2003;73:938–43CrossRefGoogle Scholar
4 Alves, CB, Loughran, S, MacGregor, FB, Dey, JI. Bioplastique medialisation therapy improves the quality of life in terminally ill patients with vocal cord palsy. Clin Otolaryngol 2002;27:387–91CrossRefGoogle ScholarPubMed
5 Wolfe, V, Long, J, Youngblood, HC, Williford, H, Olson, MS. Vocal parameters of aerobic instructors with and without voice problems. J Voice 2002;16:5260CrossRefGoogle ScholarPubMed
6 Webb, AL, Carding, PN, Deary, IJ, MacKenzie, K, Steen, N, Wilson, JA. The reliability of three perceptual evaluation scales for dysphonia. Eur Arch Otorhinolaryngol 2004;261:429–34CrossRefGoogle ScholarPubMed
8 Enderby, P, John, A. Therapy Outcome Measures: Speech-Language Pathology. San Diego, London: Singular Publishing, 1997Google Scholar
9 Rontal, E, Rontal, M. Permanent medialization of the paralyzed vocal cord utilizing botulinum toxin and Gelfoam. J Voice 2003;17:434–41CrossRefGoogle ScholarPubMed
10 Rontal, E, Rontal, M, Morse, G, Brown, EM. Vocal cord injection in the treatment of acute and chronic aspiration. Laryngoscope 1976;86:625–34Google ScholarPubMed
11 Efthimiou, J, Higenbottam, T, Holt, D, Cochrane, GM. Plasma concentrations of lignocaine during fibreoptic bronchoscopy. Thorax 1982;37:6871CrossRefGoogle ScholarPubMed
12 Zagólski, O, Carlson, E. Electroglottographic measurements of glottal function in vocal fold paralysis in women. Clin Otolaryngol Allied Sci 2002;27:246–53CrossRefGoogle ScholarPubMed