Injection laryngoplasty is one of the methods used for alleviating the symptoms of patients with vocal fold paralysis. The paralyzed or immobile vocal fold is approximated to the healthy or mobile fold by this method. As a result, the gap between the vocal folds is closed. This supplies an increase in vocal quality. It also enables better airway protection. As the vocal folds are able to be closed, consumed food and liquids do not penetrate the airway, hence, the trachea and the lungs are protected.
You may watch the examination videos of two different patients with vocal fold paralysis below:
The most common reasons are cigarette smoking (tobacco use), laryngopharyngeal reflux (backflow og acidic stomach content to the throat) and long term voice overuse or misuse. Repeated or chronic upper respiratory tract infections and frequent throat clearing are also cofactors that can cause Reinke’s edema.
Signs and Symptoms
The mass and volume of the vocal folds increase. This leads to a lower pitch in the voice. Speaking and singing needs more vocal effort and is instable.
Surgical treatment (phonomicrosurgery) is indicated. However, before and after surgery, the causes that result in the pathology, must be corrected. If the patient quits smoking, if the reflux is treated and if a hygienic vocal behaviour is adapted, recurrence is not likely. If it is done by an experienced surgeon, both vocal folds may be operated simultaneously. In the early postoperative period, vocal effort may increase for a short period of time. This is secondary to the removal of the oedema, which leaves a gap between the vocal folds that is not present before. This aspect is the most important part of surgery. An important amount of the thin and fragile epithelium covering the oedema must be left in place and should never be resected completely. Further resection may lead to scar and longer lasting vocal problems.
Recurrence of Reinke´s oedema is unlikely following a surgery in experienced hands. An important improvement of voice is expected after surgery. Hygienic vocal behaviour, ie. cessation of smoking and proper vocal use elongates these good results.
Haldun OGUZ, M.D., Professor of Otolaryngology – Head & Neck Surgery
Telephone: +90 312 284 28 88
GSM: +90 531 431 06 94
Address: Neorama İş Merkezi Kat 5 No.20 Söğütözü, Ankara