An in-office vocal fold injection augmentation is recommended when the vocal folds do not close in the midline completely (glottal incompetence). This occurs when the vocal folds lack bulk or tone from normal aging (vocal fold atrophy/aging voice) or when the vocal folds do not move properly from vocal fold paresis and paralysis. A novel approach to treatment of glottal incompetence is performing this in an awake procedure in the office.

An in-office vocal fold injection takes only around 30 minutes. Patients do not undergo general anesthesia and are usually able to continue anticoagulants such as aspirin or Plavix. Since no sedation is required, patients may drive themselves home after the appointment. Patients are also allowed to eat prior to the procedure.  

In-Office Vocal Fold Injection Augmentation Details 

In-Office Vocal Fold Injection Augmentation exampleThe patient is seated in an exam chair in our procedure room at the Voice and Swallowing Disorders Center. The nose and throat areas are numbed with medication that is sprayed into the nose or mouth, nebulized into the mouth like an asthma medication, or dripped onto the throat with the scope used during the procedure.

A flexible camera scope is passed into the nose to bring the larynx (voice box) into view. It is normal to cough or feel a choking sensation during this part of the procedure. As your throat becomes numb, you may have the sensation that your throat is swollen and it may feel difficult to swallow. These sensations are an absolutely normal phenomenon and will soon subside as the anesthetic begins to wears off after the procedure. A very small needle is used to deliver the injection filler material, either through the mouth or through the skin of the neck. You may be asked to speak during the procedure to determine the exact amount of material needed to close the gap between the vocal folds. 

In-Office Vocal Fold Injection Augmentation Post-procedure Guidelines 

Immediately after the procedure, you will be on complete voice rest for at least 24 hours. When you begin speaking after the 24 hour rest period, your voice may sound strained and may even remain “tight” for a few days to a week. This will gradually improve with time. All of the filler materials that are injected in the office are temporary and will gradually reabsorb over weeks to months. 

The patient may have a numb throat after the procedure and therefore, should not have nothing to eat or drink for 1-2 hours after the procedure. Discomfort is minimal and acetaminophen may be taken on an as-needed basis following the procedure. Risks of bleeding and infection are low. You may be asked to stay in the office for 30 minutes after the procedure for observation. 

You will have an office follow up in one month after the procedure or sooner if needed. You may contact the office at 336-716-4161 during business hours or reach out via your MyWakeHealth account if you have any questions or concerns following the procedure.