Trans-Oral Approach

Trans-oral vocal fold injection is the only non-percutaneous approach for vocal fold augmentation routinely performed in awake patients. With this approach, the operator manipulates a curved needle from the oral cavity to the glottis, visualizing with assistant-driven flexible trans-nasal or surgeon-driven rigid peroral laryngoscopy. This is a technically challenging approach predicated on the coordinated abilities of the surgeon and assistant. Moreover, success is highly dependent on patient factors, as unfavorable anatomy or a strong oropharyngeal gag may preclude completion of the procedure. Despite this, the trans-oral approach provides excellent needle control allowing for high precision in directing needle placement and controlling the nature of vocal fold augmentation.