Unilateral recurrent laryngeal nerve paralysis causes the vocal cord t
o atrophy, leading to glottic incompetence. The voice is characterized
by hoarseness, breathlessness, rapid air escape, ineffective cough an
d aspiration. Traditional treatments of unilateral vocal cord paralysi
s include intracordal injection, laryngeal framework surgery, and lary
ngeal reinnervation for medialization of the vocal cord. In this paper
we report on a new technique of transcutaneous intracordal silicon in
jection in which the injection is made through the thyroid lamina unde
r local anesthesia monitoring fiberscopy. We performed this procedure
on 30 patients with unilateral vocal cord paralysis and later evaluate
d their post-operative voice. The silicon injection resulted in improv
ement of vocal quality, favorable clearance of sputum, and aspiration
control. We found that, since it can be performed under local anesthes
ia without hospitalization, transcutaneous intracordal silicon injecti
on should be performed as a therapy for treating unilateral vocal cord
paralysis.