Ajodaya Bai, an 87-year-old lady from Telangana suffered from vocal cord paralysis for five months. She had Idiopathic vocal cord paralysis, where the nerve impulses to the voice box (larynx) were disrupted, and no major cause of paralysis could be identified. She was suffering from a weak voice and frequent aspiration, which could have an impact on her health overall. Considering her age and health status, she underwent Injection laryngoplasty with Hyaluronic acid gel under the care of Dr Manusrut, a Consultant ENT, Head and Neck Surgeon at Yashoda Hospitals Hyderabad. This material, the acid gel is frequently used in cosmetic procedures as skin filler. Ajodaya Bai had immediate improvement in her voice with reduced aspiration. It is said that the effects last for around one year and the procedure can be repeated if required. Another patient, from Telangana, 50-year Srinivasulu from Telangana who suffered from Lung cancer, which involved the nerve of the vocal cord causing vocal cord paralysis was also treated at Yashoda Hospitals Hyderabad. Injection laryngoplasty was performed on him to restore his voice.

Speaking about the procedure, Dr Manusrut, Consultant ENT, Head and Neck Surgeon at Yashoda Hospitals said, “Injection medialization laryngoplasty is a procedure that provides bulk to a vocal fold, which is a part of a muscle on the side of the larynx, covered with special tissues that can vibrate at a high speed. This is a procedure for patients who have lost their voice due to paralysis of one of the vocal cords and can be fixed with a biocompatible material injection to add this bulk and bring the vocal cord closer to the centre of the larynx. One can undergo this procedure within days of diagnosing the vocal cord paralysis, thus improving the overall quality of life. Patients with one-sided vocal cord paralysis have a gap in between the two cords, causing a weak and lower quality of voice. This happens because air leaks through the gap, they can talk for only a few seconds while also feel severely breathless. Fortunately, this is a daycare procedure and patients can go home within an hour of being injected.”

How is the Procedure Done?

The most dreaded effect of this condition is that water and saliva enter through the gap into the lungs which is known as aspiration and can lead to frequent coughing and pneumonia. In this procedure, a fine needle is passed through the neck into the paralysed vocal cord and the material is injected into it, adding bulk and virtually moving it towards the midline covering the gap. The procedure is done with the vocal cords under vision by using a slim flexible endoscope passed through the nose.

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Ideal candidates for Injection MedialisationLaryngoplasty

Some of the conditions which can lead to vocal cord paralysis are:

• Post-surgery for Thyroid, anterior cervical disc, brain tumour or of the chest.
• Cancers involving the nerve, brain or skull base tumours, thyroid cancer, lung cancers, oesophagus cancers.
• Trauma to the neck or chest, strokes and other neurological diseases.

Dr Manusrut further added, “This technique can be used to treat other voice conditions like- spasmodic dysphonia, sulcus vocalis, vocal cord atrophy, voice changes in parkinsonism etc. The process is a safe and successful option for elderly patients with vocal cord paralysis and vocal handicap.”

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