Combined ultrasound/endoscopy-assisted vocal fold injection for unilateral vocal cord paralysis: a case series.

Abstract

Transcutaneous vocal cord injection is a popular treatment choice for patients suffering from unilateral vocal cord paralysis. Transcutaneous transcartilaginous (through the thyroid cartilage) approach abolishes any anatomical constraint to reach the vocal cord. However it is a largely blind procedure as the needle should stay submucosal. Herein we report our experience in employing ultrasound guidance to circumvent this problem. Retrospective review of a series of 8 patients who underwent combined ultrasound/endoscopy-assisted vocal cord injection for unilateral vocal cord paralysis. Vocal cord injections were successfully completed in all but one patient. There were no associate complications. The use of ultrasound in aiding transcutaneous transcartilaginous vocal cord injection is safe and feasible. • Vocal cord injection is effective in treating unilateral vocal cord paralysis • A number of transcutaneous approaches with the patient awake have been described • Transcutaneous transcartilaginous approach theoretically has minimal anatomical restraint to reach the vocal cord • Disadvantage of that approach is the difficulty to accurately position the needle • Our experience of using ultrasound to circumvent this problem is positive.