Name of the Procedure:

Laryngoscopy, flexible; with injection(s) for augmentation (e.g., percutaneous, transoral), unilateral

Summary

A flexible laryngoscopy with injection for augmentation is a medical procedure used to examine the vocal cords and throat using a flexible tube with a camera. In this procedure, a substance is injected to improve the function of the vocal cords. It is done on one side (unilateral).

Purpose

This procedure addresses issues like vocal cord paralysis or atrophy that affect voice quality and breathing. The goal is to improve the voice, prevent aspiration, and enhance airway function.

Indications

• Hoarseness or weak voice
• Difficulty swallowing (dysphagia)
• Breathing difficulties due to vocal cord dysfunction
• Unilateral vocal cord paralysis or atrophy

Preparation

• Fasting for 6-8 hours before the procedure
• Adjustments in medications as directed by the physician
• Pre-procedure diagnostic tests such as imaging or speech evaluation

Procedure Description

1. The patient is positioned comfortably, usually in a reclined chair or bed.
2. Local anesthesia or mild sedation may be administered for comfort.
3. A flexible laryngoscope is inserted through the nose to view the throat and vocal cords.
4. Through the laryngoscope, a needle is guided to inject the augmentation material (e.g., gel or fat) into the affected vocal cord.
5. The injected substance adds bulk to the vocal cord, improving its function.

Duration

The procedure typically takes about 30-45 minutes.

Setting

The procedure is usually performed in an outpatient clinic or surgical center.

Personnel

• ENT (Ear, Nose, and Throat) specialist or laryngologist
• Nursing staff
• Possibly an anesthesiologist if sedation is used

Risks and Complications

• Soreness or discomfort in the nose or throat
• Risk of infection at the injection site
• Swelling or bruising
• Possible temporary worsening of voice or breathing
• Rarely, an allergic reaction to the injection material

Benefits

• Improved voice quality
• Enhanced ability to swallow and breathe
• Reduction in aspiration risk
• Benefits are often noticeable within a few days to weeks following the procedure

Recovery

• Mild throat discomfort is common and can be managed with over-the-counter pain relievers and throat lozenges.
• Avoid strenuous voice use for a few days.
• Follow-up appointments to assess the success of the injection and monitor recovery.
• Most patients can resume normal activities within a day or two.

Alternatives

• Voice therapy
• Vocal cord surgery
• Observation and lifestyle modifications
• Pros and cons of alternatives vary; therapy might take longer to show benefits, surgery might have more risks.

Patient Experience

• During the procedure, patients might feel slight pressure or discomfort from the laryngoscope and the injection.
• Post-procedure soreness is usual but manageable.
• Pain management includes mild analgesics and throat care measures.