Injection laryngoplasty according to the pathologic condition

Abstract

Injection laryngoplasty is done based on the pathologic condition of the larynx. Autologous fat was harvested and endolaryngeal microsurgery conducted for injection laryngoplasty under general anesthesia. For glottic incompetence caused by bilateral atrophy of vocal fold mucosa lamina propria, autologous fat was injected into vocal fold mucosa and into the muscle just below mucosa. For glottic incompetence with a unilateral midcord gap caused by unilateral atrophy of the vocalis muscle, fat was injected into the thyroarytenoid muscle at the membranous portion of the vocal fold. In a patient with a unilateral midcord gap and a large posterior gap, autologous fat was injected into the thyroarytenoid muscle lateral to the oblong fovea of the arytenoid cartilage to arytenoid adduction. For glottic incompetence with a unilateral midcord gap and a large posterior gap, consequently afflicted with voice disorder and aspiration, fat was injected into the vocal fold, false vocal fold, aryepiglottic fold of the larynx, and the medial wall of the piriform sinus of the hypopharynx. Lipoinjection into the vocal fold, false vocal fold, and aryepiglottic fold enabled laryngeal closure. Lipoinjection into the piriform sinus lowered its capacity and residual food was reduced and pharyngeal clearance on the affected side was improved. The injected portion and the amount of injected material should be modified at injection laryngoplasty based on the pathologic condition of the larynx.