Phonosurgery: Transoral Endoscopic Techniques

  • Christian SittelEmail author


Injection laryngoplasty is a transoral technique of vocal fold augmentation in order to close or reduce glottic insufficiency. Unilateral vocal fold paralysis is the most important indication. The technique is an alternative to thyroplasty in many cases, an adjuvant treatment in some. Both options should be offered to the patient and should be considered complementary. Technically, the injection can be done under general anaesthesia or office based in the awake patient. Advantages and disadvantages of both approaches are discussed. There is a variety of injection materials with significant differences in characteristics, mode of application and indication. A review of substances available and used in clinical routine is performed. With proper patient and material selection, injection laryngoplasty plays a major role in the treatment of many patients with dysphonia.


Vocal fold injection Vocal fold insufficiency Vocal fold augmentation Injection laryngoplasty material Injection laryngoplasty substance Office-based laryngoplasty Voice rehabilitation Vocal fold paralysis Vox Implants Polydimethylsiloxane Collagen Calcium hydroxylapatite Autologous fascia Hyaluronic acid Cymetra Radiesse Recurrent laryngeal nerve 

Supplementary material

Video 10.1

Injection laryngoplasty with Vox Implants in suspension microlaryngoscopy. Procedure documented in real time without editing (MP4 44646 kb)

Video 10.2

Subglottic overfilling, avoiding passive mobility of the stiffened vocal fold with poor functional outcome (MP4 5985 kb)

Video 10.3

Delicate and atrophic vocal folds in an elderly woman. PDMS particles can be repositioned well immediately after injection (MP4 31325 kb)

Video 10.4

Severe dysphonia due to complete unilateral recurrent laryngeal nerve paralysis following partial pneumonectomy for bronchial carcinoma (MP4 1410 kb)

Video 10.5

Endoscopic view, same patient as Video 10.4 (MP4 5245 kb)

Video 10.6

Voice result 3 weeks post Vox Implants laryngoplasty, same patient as Video 10.4 (MP4 1855 kb)

Video 10.7

Endoscopic view, same patient as Video 10.6 (MP4 3924 kb)


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology/Head and Neck SurgeryKlinikum StuttgartStuttgartGermany

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