Percutaneous Injection Laryngoplasty
What is Percutaneous Injection Laryngoplasty?
Percutaneous Injection Laryngoplasty is a new method developed to improve the operating procedures using electromyogram. Percutaneous Injection Laryngoplasty is used to treat Vocal Fold Paralysis.
The vocal folds are brought together by the action of laryngeal nerves, so that air pressure builds up beneath the larynx, generating sound through the rhythmic opening and closing of the vocal folds. However, when the nerves are paralyzed or in vocal cord paralysis, the vocal folds do not open or close properly and remain open, leaving the airway passage and the lungs unprotected. It causes hoarseness and coughing because the food goes down and gets stuck in the trachea.
This condition is called vocal fold paralysis. When only one side is paralyzed, it is called unilateral vocal fold paralysis, and when both sides are paralyzed, it is called bilateral vocal fold paralysis.
Without the need of anesthesia, this new process (Percutaneous Injection Laryngoplasty) preserves major vocal membrane and vocal layer, and allows for inserting an organic prosthesis in the right place. The electrymyogrammic needle helps to spot and insert the material, improving the voice dramatically almost permanently.
Electromyogram was tested approximately 1000 times on animals, and was first introduced in 1991. Clinical studies were presented to the National Learned Society (4th Korean Otolaryngology General Learned Society Presentation 1998), as well as to the International one (2nd East Asian Orthopedic Learned Society), and it was also presented at the 32nd American Voice Learned Society in Philadelphia on June 8th 2003 (The Voice Foundation’s 32nd Annual Symposium).
Precautions for the Patient of Vocal Fold Paralysis
Percutaneous injection Laryngoplasty through transcricothyroid membrane and transthyroid cartilage approaches requires high expertise and the complete knowledge of the internal and external anatomy of the larynx. The palpation of the cartilage and membrane allows accurate insertion of the needle through the skin. The subsequent step is to bend the needle to point towards the paraglottic space. The video on the monitor enables accurate needle placement and help estimate the amount of injectables that is sufficiently needed to ameliorate vocal fold and glottis closure.
Sufficient care should be taken to prevent the injection superficially or to excessively inject an airway. The adept knowledge of the technique enables the development of the patient care by limiting the time of surgery, not requiring general anesthesia, avoiding the risks of direct laryngoscope, direct visualization and reduction of the recovery time enabling a patient rapid procedure.
Advantages of Injection Laryngoplasty
- General anesthesia is not necessary.
- It only takes about fifteen to twenty minutes operation.
- Treatment is possible irrespective of health condition of the patient.
- Hospitalization is not required.
- Incision is not required.
- Different treatments are available through different drugs in accordance with the patient’s condition.
- Insertion in the right area is possible depending on the illness of patients.