Indications for vocal fold augmentation with collagen.

Background: Vocal fold augmentation through an indirect laryngoscopic injec tion has been largely supplanted by the external approach of vocal fold med ialization. Vocal fold augmentation with collagen is still of clinical impo rtance for the temporary treatment of glottic insufficiencies. The differen t elimination time of certain collagen compounds in the vocal fold tissue e nables individual therapeutic applications. Patients and Methods: The colla gen compounds Zyderm(R) I and II and Zyplast(R) were injected into the voca l fold in 37 patients with neurogenic glottic insufficiency and 2 patients with vocal fold atrophy during indirect laryngoscopy. The choice of compoun d was made depending on the case, prognosis, severity of the disorder, the persistance of the glottic insufficiency, and the patient's age and conditi on. Results: Thirty-three patients showed an significant improvement of the glottic closure. However, 6 patients showed hardly any change. Conclusion: Collagen augmentation can be used for the temporary medialization of the v ocal fold. It is a suitable method for the treatment of vocal fold paralysi s a) within the neural regeneration time, and b) in patients with reduced c ondition and/or a short life expectancy due to severe diseases.