Abstract
Twenty-three patients, complaining of hoarseness due to unilateral recurrent laryngeal nerve (RLN) palsy, underwent vocal fold augmentation by an intracordal injection of atelocollagen. Sixteen of them were followed over seven months (7 months-7 years and 7 months, average 3 years and 5 months). Ten of these 16 maintained improved phonatory functions during a follow-up period and were classified as Group 1. Four of this group showed highly disturbed pre-injection phonatory functions more than the rest of Group 1 and were not satisfied with their post-injection voices. Two of these four underwent type I thyroplasty and another re-injection. The other six of Group 1 included three patients after arytenoid adduction. Group 2, including another four, did not show any improvement in their post-injection phonatory functions. Two of them underwent type I thyroplasty and re-injection, respectively. The other two (Group 3) showed a progressive improvement in their post-injection phonatory functions.
A major disadvantage of intracordal injection of collagen injection is a remarkable decrease in volume of the paralyzed vocal fold during a follow-up period. Repeated injection or type I thyroplasty is the choice for such a post-injection dysphonia. Collagen injection is not indicated. when the both vocal processes do not meet during phonation. Such a case requires arytenoid adduction combined with collagen injection or type I thyroplasty.
