Abstract
Dysphonia associated with laryngeal paralysis may be identified in the short term postoperatively or may develop years after successful arytenoid adduction. In selected cases, collagen injection of vocal fold improves phonation after arytenoid adduction. Our experience with the use of collagen injection to supplement arytenoid adduction is reported. Forty patients were treated with transoral collagen injection into the atrophic vocal fold after arytenoid adduction at The University of Tokyo from January 1990 to December 2005. These patients all had a diagnosis of unilateral vocal fold paralysis. Voice quality (GRBAS scale) and the other examinations for vocal function demonstrated measurable improvement after treatment. After arytenoid adduction, maximum phonation time (MPT) improved from 5 to 11 s and mean flow rate (MFR) as an aerodynamic examination improved from 772 to 322 ml/s. Voice quality, especially roughness, improved from 1.8 to 0.8 after collagen injection. MPT (from 11 to 14 s) and MFR (from 322 to 233 ml/s) showed overall improvement after collagen injection. We will report the ease with which transoral collagen injection was accomplished and how better voice quality was attained without the more extensive surgery. In the session techniques of anesthesia, injection, and patient selection are discussed.
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