Collagen injection into the vocal folds via an anterior commissure

• Published in: OTOLOGIA FUKUOKA Vol. 42; no. 5; pp. 546 - 550
• Main Authors: HANYU, Youko, KITAHARA, Satoshi, SATO, Michiya, OGURA, Masami, YAMAGUCHI, Kengo, OHMAE, Yukio, TAMURA, Etsuyo, MORIKAWA, Hiroshi, INOUE, Tetsuzo
• Format: Journal Article
• Language: Japanese
• Published: JIBI TO RINSHO KAI 20.09.1996
• Subjects: アテロコラーゲン; 前連合; 声帯内注入術; 声帯粘膜硬化病変; 音声障害
• ISSN: 0447-7227; 2185-1034
• DOI: 10.11334/jibi1954.42.5_546

A traumatic or surgical invasion of the vocal folds often creates scar tissue on the vocal folds. Voice disorders due to such scar tissue on the vocal folds have thus been increasingly reported. Voice therapy and/or injection therapy into the vocal folds has thus been developed for such voice disorders but the success rate has not proved to be satisfactory. We consider that the intra-mucosal injection of atelocollagen does not interfere with vocal cord vibration as is therefore effective. However, an efficient injection using the current methods for laryngomicrosurgcry remains technically limited. We thus experimented with intra-mucosal injection via an anterior commissure to avoid reversion and to aid in accurate needle placing. We experimented on 3 dogs, consisting of 6 vocal folds. The center of the thyroid cartilage was scraped to expose the ligament of the anterior commissure. We used 3.0% atelocollagen as the injective material; while to stabilize the injection needle, a plastic board with pinholes, perforated at 1 mm intervals, was also used. A guide wire was inserted into the laryngeal cavity via the anterior commissure through one of the pinholes on the plastic board. Then, utilizing surgical microscopy, the wire was placed on the free edge of the vocal folds. Collagen was thus injected through a pinhole 2 holes lateral and one hole caudal to the wire. Thereafter, from 45-75 days after the injection, the larynx was removed in order to observe the vocal fold vibrations under simulated phonation, then they were fixed in formaline and sliced for HE staining to explore the injected site. The collagen sites included: in the superficial layer of the lamina propria in 3 folds, in the medial layer in 2 folds, and in the profound layer in 1 fold.