Intracordal Injection for Unilateral Vocal Cord Paralysis

Abstract

We administered an intracordal injection of silicone or fat to 114 cases with unilateral vocal cord paralysis between January 1983 and December 1997. The primary injection method was transcutaneous (100 cases). The injection material used in most cases was silicone, but in recent years fat has been injected instead. There was no difference in outcome related to injection procedures. Regarding injection technique, the three prerequisite conditions which resulted in a good post-operative voice were as follows: the position of the paralyzed vocal cord was close to the median line; atrophy of the vocal cord was less; and the two vocal cords did not differ in height. Recent progress in surgical techniques, as well as an increased incidence of cancer such as lung cancer and esophageal cancer, has resulted in an increase in the number of cases of laryngeal paralysis after surgical treatment of malignant tumors. Since reported human-adjuvant disease in conjuction with the use of silicone, alternatives to silicone have been in demand. The manipulation of fat however, remains difficult and we anticipate the development of an injection material which is more easily manipulated, non-absorbed, and which induces minimal tissue response.