Injection laryngoplasty in pediatrics

Abstract

Injection laryngoplasty is a procedure that provides support to a vocal fold that lacks either the bulk or the mobility it once had. Two indications are vocal fold immobility from vocal fold paralysis, scarring, or atrophy among other causes or glottic insufficiency resulting from vocal atrophy, sulcus vocalis, or vocal fold neoplasm. A comprehensive pre-operative work up includes evaluation of the vocal folds by indirect flexible laryngoscopy, stroboscopy, direct operative laryngoscopy, and/or ultrasound. Measuring impacts of vocal pathology that may be suited to injection laryngoplasty is done through pediatric reported outcome measures of voice and evaluation of swallow. During the operation the surgeon can choose from different injection materials depending on the need of the procedure. In children, the most typical method of delivery in children is under direct or telescopic and/or microscopic visualization during a procedure under anesthesia. The surgeon must take caution for proper placement of material in relation to the true vocal fold to reduce risks of voice dysfunction, airway obstruction, airway hemorrhage, or injury to the adjacent laryngeal structures. Injection laryngoplasty is the preferred method of surgical management of vocal fold immobility and has proven safe in children of all ages. Injection laryngoplasty is a procedure that provides support to a vocal fold that lacks either the bulk or the mobility it once had. Two indications are vocal fold immobility from vocal fold paralysis, scarring, or atrophy among other causes or glottic insufficiency resulting from vocal atrophy, sulcus vocalis, or vocal fold neoplasm. A comprehensive pre-operative work up includes evaluation of the vocal folds by indirect flexible laryngoscopy, stroboscopy, direct operative laryngoscopy, and/or ultrasound. Measuring impacts of vocal pathology that may be suited to injection laryngoplasty is done through pediatric reported outcome measures of voice and evaluation of swallow. During the operation the surgeon can choose from different injection materials depending on the need of the procedure. In children, the most typical method of delivery in children is under direct or telescopic and/or microscopic visualization during a procedure under anesthesia. The surgeon must take caution for proper placement of material in relation to the true vocal fold to reduce risks of voice dysfunction, airway obstruction, airway hemorrhage, or injury to the adjacent laryngeal structures. Injection laryngoplasty is the preferred method of surgical management of vocal fold immobility and has proven safe in children of all ages.