Techniques of Injection Laryngoplasty Under Local Anaesthesia in Unilateral Vocal Fold Paralysis: A Systematic Review

To compare the efficacy of vocal results and the occurrence of pulmonary complications of different techniques of injection laryngoplasty under local anaesthesia in unilateral vocal fold paralysis (UVFP).

A systematic review of the literature was carried out and selected studies evaluating the efficacy and safety of transnasal, transoral, or transcutaneous injection laryngoplasty in iatrogenic, traumatic, tumoral, or idiopathic UVFP. The equation [(unilateral) AND ((vocal fold) OR (laryngeal) OR (vocal cord)) AND ((injection) OR (laryngoplasty)) AND ((office) OR (in-office) OR (local) OR (outpatient))] was used in an analysis of the literature over a period from 1995 to 2022.

Seventeen articles were retained for the final analysis. Among the 634 patients having undergone a single technique of injection laryngoplasty under local anaesthesia, 27 patients (4%) had medialisation by injection by transnasal route, 103 (17%) by transoral route, and 504 (79%) by transcutaneous route. Among the 278 patients having undergone analysis of maximum phonation time, an improvement of 4.57 ± 2.3 s was noted after the injection.

Injection laryngoplasty under local anaesthesia of UVFP is a reliable and safe technique enabling improved voice quality. The different techniques lead to improved vocal results similar to those found under general anaesthesia.