Effect of temporary vocal fold injection medialization on the rate of permanent medialization laryngoplasty in unilateral vocal fold paralysis patients

OBJECTIVES/HYPOTHESIS: To determine whether temporary vocal fold injection affects the need for permanent medialization laryngoplasty in patients with unilateral vocal fold paralysis (UVFP). STUDY DESIGN: Retrospective chart review. METHODS: A total of 175 patients with dysphonia resulting from UVFP were identified. Patients with documented recovery of vocal fold mobility, <9 months of follow-up after diagnosis of UVFP, previous treatment at other institutions, neoplastic disease involving the larynx, or history of radiation to the larynx were excluded. Fifty-four patients met all inclusion/exclusion criteria. Rates of permanent medialization laryngoplasty in patients undergoing vocal fold injection were compared with those of patients who chose observation or voice therapy. RESULTS: A total of 35% of patients underwent temporary injection medialization, and the remaining 65% chose conservative management. Five of 19 of the temporary injection medialization patients subsequently underwent permanent intervention compared to 23 of 35 of the conservative management group (P = .0131). CONCLUSIONS: UVFP patients who underwent vocal fold injection with an agent intended to provide temporary medialization were statistically significantly less likely to undergo permanent medialization laryngoplasty compared to those patients who were treated with conservative management only.