Injection laryngoplasty

Injection laryngoplasty was originally introduced in 1911 by Bruening for the management of dysphonia secondary to unilateral vocal fold paralysis. By the early 1960s, Teflon had become the most commonly employed substance for injection. Because of an unpredictable inflammatory response in the host to the Teflon and a poor viscosity match between the Teflon and the vibratory membrane of the vocal fold, however, the search has been ongoing for an alternative substance. Silicone, cartilage, bone powder, fat, fascia, collagen, hyaluronan, and hydroxyapatite have been used. The choice of substance is dependent on the cause of the glottic insufficiency creating the dysphonia as well as on the layer of the vocal fold to be injected. An understanding of laryngeal histology and physiology enables the surgeon to evaluate the potential options better.