Injection laryngoplasty for unilateral vocal fold paralysis

Abstract

Unilateral laryngeal paralysis is often caused by diseases of the cervicothoracic region. Approximately 50% of cases occur after intubation and other surgical procedures, and the number of cases is likely to increase in the future. Conservative therapy and phonosurgery play a significant role in the treatment of dysphonia accompanying unilateral laryngeal paralysis. In the present study, factors affecting the level of postoperative vocal improvement in injection laryngoplasty were investigated, and the transition time from voice therapy to surgical procedure was examined. The present study findings showed that the maximum phonation time prior to injection thyroplasty was often shorter in relatively older patients, i.e. patients aged ≥60 years, compared to those aged <60 years, and that this shortening had an effect on postoperative vocal improvement. Age also had an impact in patients who required surgical procedure due to insufficient vocal improvement with voice therapy alone. Based on our findings, we consider that injection laryngoplasty is a viable initial therapy that should be performed early on and without a waiting period in relatively older patients with diminished QOL because it does not involve incision of the skin and has few complications.