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After 9 months of observation, should the paralysis not resolve and the patient be dissatisfied with the outcomes of voice therapy, the next option is temporary injection medialization.[1] In this procedure, a variety of materials can be injected into the body of the vocal fold in order to bring it closer to the midline of the glottis.[1] Materials such as Teflon, autologous fat, collagens acellular dermis, fascia and hydroxyapatite are available to be used in the procedure.[2] The choice of substance is dependent on several factors, it takes into consideration the specific condition and preference of the patient as well as the clinical practice of the surgeon. [3] The purpose of the various injection types is to fill up the vocal folds and increase their volume. Longevity of the injection varies on the product used and how quickly it gets reabsorbed by the body [2] This procedure allows the paralyzed vocal fold to make contact with the alternate fold, in order to more efficiently produce phonation.[1] While injection augmentation has been long considered best practice, neither technique nor materials used have been standardized across clinicians.[1] With this, results prove to be both safe and effective, but variable in their duration, lasting anywhere from 2 to 12 months.[4]
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- ^ a b c d Sulica, Lucian; Rosen, Clark A.; Postma, Gregory N.; Simpson, Blake; Amin, Milan; Courey, Mark; Merati, Albert (2010-02-01). "Current practice in injection augmentation of the vocal folds: Indications, treatment principles, techniques, and complications". The Laryngoscope. 120 (2): 319–325. doi:10.1002/lary.20737. ISSN 1531-4995.
- ^ a b Colton, Raymond; Casper, Janina; Leonard, Rebecca (2011). Understanding voice problems A physiological perspective for diagnosis and treatment. Baltimore, MD: Lippincott Williams & Wilkins. pp. 300–303. ISBN 978-1-60913-874-5.
- ^ Shen, Tianjie; Damrose, Edward J.; Morzaria, Sanjay (2012-10-16). "A Meta-analysis of Voice Outcome Comparing Calcium Hydroxylapatite Injection Laryngoplasty to Silicone Thyroplasty". Otolaryngology-Head and Neck Surgery. 148 (2): 197–208. doi:10.1177/0194599812464193. ISSN 0194-5998.
- ^ Costello, Declan. "Change to earlier surgical interventions". Current Opinion in Otolaryngology & Head and Neck Surgery. 23 (3): 181–184. doi:10.1097/moo.0000000000000156.