Vocal cord medialization and Sulcus-vocalis surgical management

Complete or partial paralysis of one or both vocal cords can significantly affect a patients phonation ability as well as risk aspiration. Sulcus vocalis is a condition where there is a groove running parallel to the edge of the vocal cord extending from the anterior commissure to the anterior edge of the vocal process of the arytenoid cartilage. Injection laryngoplasty (IL) is a minimally invasive technique which can successfully deal with both of the above-mentioned conditions directly as well as indirectly with only a slight modification in technique using autologous ‘insulinated fat’. Additionally, when treating sulcus vocalis, cold steel dissection of the sulcus through a small parallel incision was preferred without subsequent mucosal suturing. Using 2 surgeons (4 hand technique) improves precision of instrumentation when using a high-definition rigid bronchoscope through a suspension laryngoscopy setup. This is needed especially for precision injection of long-term injectables in injection laryngoplasty.