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Combined ultrasound/endoscopy-assisted vocal fold injection for unilateral vocal cord paralysis: a case series
Siu Kwan Ng1, Hok Yuen Yuen, Charles A van Hasselt
1Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong, SAR, China.
Objective:
Transcutaneous vocal cord injection is a popular treatment choice for patients suffering from unilateral vocal cord paralysis. Transcutaneous transcartilaginous (through the thyroid cartilage) approach abolishes any anatomical constraint to reach the vocal cord. However it is a largely blind procedure as the needle should stay submucosal. Herein we report our experience in employing ultrasound guidance to circumvent this problem.
Methods:
Retrospective review of a series of 8 patients who underwent combined ultrasound/endoscopy-assisted vocal cord injection for unilateral vocal cord paralysis.
Results:
Vocal cord injections were successfully completed in all but one patient. There were no associate complications.
Conclusion:
The use of ultrasound in aiding transcutaneous transcartilaginous vocal cord injection is safe and feasible.
Key Points:
• Vocal cord injection is effective in treating unilateral vocal cord paralysis • A number of transcutaneous approaches with the patient awake have been described • Transcutaneous transcartilaginous approach theoretically has minimal anatomical restraint to reach the vocal cord • Disadvantage of that approach is the difficulty to accurately position the needle • Our experience of using ultrasound to circumvent this problem is positive.
