The value of injectable collagen in vocal and glottic rehabilitation

In 1962, Arnold used injectable Teflon to reintroduce Brünings' technique for rehabilitating the paralysed vocal cord. Although Teflon would not appear to be carcinogenic, the technique is not entirely trouble-free. Injectable collagen as a biological implant seems to be an attractive alternative since it is a component part of the extracellular protein matrix. In actual clinical use, the collagen is easily injectable, is well-tolerated by patients, and is only subject to limited resorption. It also undergoes some transformation into living connective tissue with neovascularization. Our study was carried out on 14 patients: 13 had vocal cord paralyses from various causes and 1 had vocal cord atrophy as a sequel to traumatic injury. The therapeutic indication for correction in all of these patients was dysphonia for which speech therapy had failed to produce an adequate result. One patient was found to suffer from symptomatic aspiration as well. The actual technique of surgery involved the injection of a mean quantity of 1.5 cc collagen into the submucosal tissue of the affected cord during direct laryngoscopy. Postoperatively, all of our patients showed improved dysphonia without secondary effects occurring from the collagen. We also found lessened aspiration in our patient so affected. Our period of follow-up to date ranges from 3-12 months.