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Abstract
Dysphonias resulting from incomplete gloitic closure or inadequate vocal fold tension are eligible for phonosurgical correction. Many different phonosurgical techniques have been used for thest indi cations.$).
A still frequently applied method to achieve medialization in cases of incomplete glottic closure is the endolaryngeal injection of soluble substances, such as teflon, silicon, or collagen and more recently autologous fat. Such treatments with injectable substances are quick and appareittly simple procedure, however they are associated with considerable disadvantages and risks (5.):
I. The mass, volume, and stiffness of the injected vocal fold is influenced by the injected substances. Such changes in vocal fold mass, volume, and stiffness negatively influences the vibratory properties of the vocal fold, which can result in a poor voice.
2. Distribution of the injected substance is difficult to control, The substance will spread according to the path of least resistance, rather than to the area requiting augmentation.
3. The tre,atment is irreversible. Overinjection is difficult to collect and generally requires partial resection of the vocal fold resulting in severe dysphonia.
4, If performed under general anesthesia, as many endolaryngeal injection procedures are, voice monitoring during the procedure is not possible. Consequently it is difficult to estimate the proper amount of substance to be injected .