Combined ultrasound/endoscopy-assisted vocal fold injection for unilateral vocal cord paralysis: a case series

Abstract

Objective: Transcutaneous vocal cord injection is a popular treatment choice for patients suffering from unilateral vocal cord paralysis. Transcutaneous transcartilaginous (through the thyroid cartilage) approach abolishes any anatomical constraint to reach the vocal cord. However it is a largely blind procedure as the needle should stay submucosal. Herein we report our experience in employing ultrasound guidance to circumvent this problem.

Methods: Retrospective review of a series of 8 patients who underwent combined ultrasound/endoscopy-assisted vocal cord injection for unilateral vocal cord paralysis.

Results: Vocal cord injections were successfully completed in all but one patient. There were no associate complications.

Conclusion: The use of ultrasound in aiding transcutaneous transcartilaginous vocal cord injection is safe and feasible.

Key points: • Vocal cord injection is effective in treating unilateral vocal cord paralysis • A number of transcutaneous approaches with the patient awake have been described • Transcutaneous transcartilaginous approach theoretically has minimal anatomical restraint to reach the vocal cord • Disadvantage of that approach is the difficulty to accurately position the needle • Our experience of using ultrasound to circumvent this problem is positive.