Vocal cord medialization

In unilateral vocal cord paresis, and to some extent in age-related vocal cord dysfunction, a medialization procedure may improve vocal cord closure during phonation and thus in turn improve voice strength and quality.

The patient is assessed during an outpatient office visit to determine which technique to use, based on voice and laryngeal findings. Stroboscopy is carried out to assess the size of the closure defect.

Methods:

Medialization according to Isshiki

Medialization using the Isshiki method is carried out under local anesthesia. The procedure involves manufacturing a plastic stent that is individually shaped for optimum effect. The stent is introduced from the outside via a fenestration on the paretic side of the thyroid cartilage. Lateralization is therefore achieved lateral to the vocal cord and in the same plane.

Hyaluronic acid injection

Hyaluronic acid can be injected directly during an office visit with no additional patient preparation. The injection is administered under mucous membrane anesthesia using a flexible fiberscope to deliver the medication directly into the vocal cord.

Injection of fat or Dextranomer

Injection of fat or Dextranomer into the vocal cord is carried out by direct laryngoscopy under full anesthesia or under local anesthesia via puncture of the cricothyroid membrane under fiberoptic guidance.