Assuntos
Doenças Ósseas/diagnóstico por imagem , Fossa Craniana Posterior/diagnóstico por imagem , Cisto Epidérmico/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Doenças Ósseas/diagnóstico , Fossa Craniana Posterior/patologia , Diagnóstico Diferencial , Cisto Epidérmico/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osso Temporal/patologia , Tomografia Computadorizada por Raios XRESUMO
The practice of injection laryngoplasty under local anesthesia has become more common as both the indications for the procedure and the number of injectable substances increased. Modifications to the injection techniques used for vocal fold augmentation have been described over the last decade that reflect changes in the established percutaneous and transoral approaches. These percutaneous and transoral injection techniques for the treatment of dysphonia secondary to glottic incompetence are well described and provide an adequate approach for most cases. However, these traditional methods may be difficult to master, require great patient tolerance, and may be impossible to perform when anatomic or physiologic barriers exist. We describe a new application of the fiberoptic transnasal endoscope to perform laryngeal injection using a flexible needle through a port in the endoscope. This technique is easily mastered and readily tolerated by patients who would not be candidates for the other injection techniques under local anesthesia. We present our favorable experience with this technique and identify its shortcomings coupled with recommendations to address future technical modifications.