COMPARING VARIOUS TREATMENTS FOR VOCAL CORD (FOLD) PARALYSIS

 Below is an abstract of a paper published several years ago describing the relative advantages and disadvantages of Teflon injection laryngoplasty vs Isshiki Medialization thyroplasty (laryngoplasty) and the ansa cervicalis-recurrent laryngeal nerve anastomosis (laryngeal reinnervation technique).  It is available online at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2221730&dopt=Abstract

 Ann Otol Rhinol Laryngol. 1990 Oct;99(10 Pt 1):759-63.
 

At UCI Medical Center’s Center for Voice and Speech Disorders,  we evaluate each individual patient with vocal cord paralysis differently.   For some patients the injection technique is preferred.   There are many new injectables available currently, and we most frequently use CyMetra^® ,  Restylane^® ,  or  Radiesse^® while the older Teflon is reserved for terminally ill patients, or for older patients who do not  want, or cannot tolerate a possible second procedure .

We use Isshiki’s Medialization Laryngoplasty (Thyroplasty) technique for many patients for whom reinnervation would not be appropriate, or when an injection technique has less to offer.   The Medialization (Silastic block, or Goretex implant) technique offers a small to moderate chance for reversibility, and is performed under local anesthesia, thus allowing Dr. Crumley a chance to assess the vocal quality improvement intraoperatively.

Our preference for most patients under the age of approximately 65 is reinnervation.   This is because in our series of ~ 90 patients, it has offered the most reliable post operative voice, often approaching normal, without any invasive procedure whatsoever into the larynx, thyroid cartilage, or vocal cord.