Vocal Fold Augmentation: Injection Laryngoplasty

Injection Laryngoplasty under LA

When IL is performed under local anaesthetic the injection is carried out with you sitting upright. The nose is prepared with a combination anesthetic and decongestant spray. A small amount of local anaesthetic is injected through the skin into the windpipe. This will make you cough for a brief time.

A flexible endoscope is placed through the nose by an assistant to allow me to see the vocal folds on a video monitor. A fine needle is placed through the skin of the neck. A small needle prick is felt when the needle enters the skin. The needle is passed either under the cartilage of the larynx (the thyroid cartilage) to enter the vocal fold from below (the most direct route), or the needle is passed over the top of the cartilage of the larynx to enter the vocal fold from above. There is a mild amount of discomfort as the needle is manipulated into position.

After the needle enters the vocal fold the filler is injected into one (unilateral injection) or both vocal folds (bilateral injection). The amount injected is determined by the appearance of the vocal fold and by the sound quality of the voice.

After the procedure, you should not eat or drink for one hour. You may drive home immediately after the procedure. Voice rest (no whispering, talking, or shouting) may be required for 2 days after the procedure, but often this is not required. Sometimes there is a mild amount of discomfort after the procedure, but this usually settles after 2 days. A simple pain reliever such as Paracetamol may be taken as required.

Injection Laryngoplasty under GA

When IL is performed under general anaesthetic (GA) the injection is carried out in the operating room in hospital. You are put to sleep by the anaesthetist. A hollow metal tube called a laryngoscope is placed through the mouth into the throat. The laryngoscope exposes the vocal folds, allowing the vocal folds to be examined.

A microscope is used to examine the vocal folds in detail, and so procedure is called a microlaryngoscopy. A very long needle is then placed through the laryngoscope and is inserted into one or both of the vocal folds. The filler is then injected through the needle until the shape and size of the vocal folds have been improved.

After the procedure, there is nothing to eat or drink for one hour. You are discharged home after about 3 hours of postoperative observation. Voice rest (no whispering, talking, or shouting) is recommended for 2 days after the procedure. Sometimes there is a mild amount of discomfort after the procedure, and this usually settles after 2 days. A simple pain reliever such as Paracetamol may be taken as required.