Vocal Cord Augmentation/Injection Laryngoplasty

Introduction

Injection laryngoplasty is performed for treatment of vocal cord paralysis, which may have a variety of causes ( Box 46.1 ). Imaging during a Valsalva maneuver demonstrates the mechanical and physiologic barriers that patients with unilateral vocal cord paralysis endure ( Fig. 46.1 ). Vocal cord augmentation procedures attempt to overcome these barriers by medializing the affected vocal fold, thus allowing for better phonation and alleviating risk for aspiration. Temporary injectable materials, which last a few weeks to a few months, include hyaluronic acid, collagen, and Gelfoam. Long-lasting and permanent agents include calcium hydroxyapatite paste, autologous fat, and polytetrafluoroethylene past (Teflon). These injected materials can be incidentally encountered on imaging obtained for other reasons, such as cancer surveillance. Alternatively, injection laryngoplasty is subject to certain complications that may warrant diagnostic imaging evaluation. Laryngoplasty evolution and potential complications, including Teflon granuloma, will be the focus of the following discussion ( Fig. 46.2 ).