The thyrohyoid approach to in-office injection augmentation of the vocal fold

The purpose of this article is to review the history of vocal fold injection augmentation and provide a thorough description of the percutaneous thyrohyoid approach to office-based vocal fold injection augmentation for the management of glottic incompetence.

A number of techniques for vocal fold injection augmentation have been developed since the first procedure was performed. Since vocal fold injection augmentation is performed without an open surgical approach, morbidity is reduced and the technique can be done in the outpatient setting. Accordingly, over the past decade there has been an effort to perfect techniques and to develop new materials and methods to make the procedure more effective and comfortable for the patient.

Recently, office-based vocal fold injection augmentation has gained significant popularity among laryngologists. While there are a variety of in-office injection techniques, the thyrohyoid approach, in the authors' opinion, is the simplest and best tolerated. This technique is effective and eliminates many of the shortcomings of the other approaches. This approach continues to be the 'workhorse' for in-office vocal fold injection augmentation in the senior author's practice. It is important, however, for any practitioner to be familiar with the other approaches, as this technique is not universally effective for all patients.