Immediate percutaneous medialization for acute vocal fold immobility with aspiration

Objectives: To determine the efficacy of immediate bedside or office percut aneous, trans-thyroidal injections of a bioabsorbable gelatin material (Gel foam, Upjohn Co., Kalamazoo, All) to decrease the risk of aspiration result ing from acute vocal fold immobility. Study Design: Retrospective review of patients presenting with acute vocal fold immobility and aspiration or hig h aspiration risk at an urban, tertiary care university hospital. Methods. All patients were evaluated by videostroboscopy, functional endoscopic eval uation of swallowing (FEES), and objective voice measures. Patients with ac ute vocal fold immobility and evidence of aspiration on history or FEES wer e given the option of medialization by Gelfoam injection. Injections were p erformed percutaneously in the office or at the bedside under laryngoscopic guidance. FEES was repeated after injection to verify improvement in aspir ation. Results. Eleven patients underwent Gelfoam injection for treatment o f aspiration and vocal fold immobility. All were significantly improved on post-injection FEES study. All patients were returned to an oral diet, avoi ding the need for long-term enteral access. Conclusion: Percutaneous Gelfoa m injections is a rapid, temporary solution to the common problem of aspira tion resulting from acute vocal fold immobility.