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Updated: Aug 28, 2025

A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
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Device Failure During Injection Medialization Laryngoplasty.

Nicole Molin1, Mursalin M Anis2, Ahmed M S Soliman1

  • 1Departments of Otolaryngology-Head and Neck Surgery Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.

Journal of Voice : Official Journal of the Voice Foundation
|September 13, 2022
PubMed
Summary

Needle failure is common during injection laryngoplasty, often due to clogging or twisting. In 25% of cases, needle tip fracture created a foreign body, requiring procedure abortion.

Keywords:
ComplicationsInjection laryngoplastyVocal foldVocal fold paralysis

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Area of Science:

  • Otolaryngology
  • Laryngology
  • Surgical Complications

Background:

  • Injection medialization laryngoplasty is a standard procedure for glottic insufficiency.
  • Complications, particularly device failure, are underreported in existing literature.

Purpose of the Study:

  • To investigate the prevalence of needle failure during injection laryngoplasty.
  • To identify common causes and consequences of needle failure in this procedure.

Main Methods:

  • A survey was distributed to members of the American Bronchoesophagological Association (ABEA).
  • Responses were collected and analyzed using descriptive statistics.

Main Results:

  • 83% of respondents reported experiencing needle failure.
  • Needle clogging (59%) and twisting (22%) were the most frequent issues.
  • Needle tip fracture occurred in 19% of failures, leading to foreign body complications in 25% of cases and procedure abortion in most instances.

Conclusions:

  • Needle failure is a significant concern in injection laryngoplasty, affecting the majority of practitioners.
  • While clogging and twisting are manageable, needle tip fractures pose serious risks, including foreign body creation and procedural termination.