Transoral Teflon injection under flexible laryngovideostroboscopy for unilateral vocal fold paralysis

Intracordal Teflon injection is a widely accepted method for the treatment of glottic incompetence due to unilateral vocal fold paralysis. It can be performed transorally via direct or indirect laryngoscopy, as well as transcutaneously under laryngovideoscopy. However, these procedures still have their disadvantages. The technique we introduce is to perform the procedure transorally while using a curved injection needle under flexible laryngovideostroboscopic monitoring. With topical anesthesia, the patient can phonate naturally during the procedure. The surgeon can visualize the needle and injection site clearly under high-resolution flexible laryngovideostroboscopy. Stroboscopic examination during surgery enables the surgeon to monitor the improvement of vocal fold vibration. Twenty consecutive patients treated with this technique were studied. The preliminary results are satisfactory. The technique we introduce is an outpatient procedure with high applicability and low morbidity. This technique is a good, cost-effective alternative to standard operative direct laryngoscopy with injection.