Intracordal injection technique: materials and injection site

Abstract

Objective: Various materials have been used for intracordal injection to treat deficiencies in glottal closure. However, specific injection sites and materials are desirable for various conditions. Here, we reviewed injection sites and materials.

Methods: By considering the characteristics of injection materials used in Japan to date as well as the normal structure of the vocal cord, we have determined injection materials and sites suitable for different type of disease.

Results: Collagen obtained commercially for injection consists mainly of type I collagen, as does autologous fascia. When this material is injected into the superficial layer of the lamina propria mucosae of the vocal cord, the wave motion of the mucosa during phonation is disturbed. This material therefore should be injected deeper into the lamina propria. Indications for collagen injection include unilateral recurrent laryngeal nerve paralysis. Even when injected into the lamina propria, fat tissue does not disturb mucosal wave motion, and is useful for treating vocal cord atrophy or sulcus vocalis.

Conclusion: When intracordal injection is used in vocal rehabilitation, material and site should be selected, based on the cause of glottal dysfunction.