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Keywords:

  • Dysphonia;
  • larynx;
  • phonosurgery;
  • vocal fold injection

Abstract

Objectives/Hypothesis:

Vocal fold (VF) injections of viscous materials are typically performed using hand-operated syringes or injection guns; however, these methods can be imprecise due to accumulation of pressure, effort-related tremor, and poor feedback regarding injection volume and rate.

Study Design:

Apparatus development with laboratory bench-top and animal model testing.

Methods:

A foot pedal-triggered device for dispensing viscous materials was modified by adding a linear transducer and display for monitoring dispensed volume. In bench tests, bovine VFs were injected with fluids/materials of different viscosities (saline, glycerol, hydrogel, and liposuctioned fat) through narrow-bore needles using a range of driving pressures and air pulse durations. The device was further evaluated in >50 in vivo VF injection experiments.

Results:

Device function was repeatable, with high correlations (typically R2 > 0.98) between the readout and direct measures of volume, even for small volumes (<5 μL/pulse). Foot pedal control enabled surgeons to make steady, accurate injections into ferret and dog VFs during phonosurgery, and, because the dispenser released all driving pressure between pulses, there were no instances of clog-related overinjection when the obstruction cleared.

Conclusions:

This VF injection system shows promise for development to enhance human phonosurgery by increasing injection control and precision. Laryngoscope, 2012