Overview of vocal cord procedures
| Procedures | Indications | Techniques | Imaging Findings |
|---|---|---|---|
| Injection laryngoplasty | Temporary correction of glottic incompetence due to unilateral vocal fold paralysis and long-term correction of mild-moderate glottic insufficiency | Percutaneous, transnasal, or peroral injection of filler material into the vocal cord or paraglottic space | Varies depending on agent injected; also refer to the text and Table 2 |
| Medialization laryngoplasty | Permanent correction; should be reserved for cases of vocal fold paralysis in which recovery of motion is definitively not expected (time >6 months from onset, surgical recurrent nerve sacrifice, or malignant invasion) | Insertion of an implant into the vocal fold through a window in the thyroid, which results in displacement of the paralyzed vocal fold to a more medial position | The implants typically used appear as hyperattenuating on CT and low signal on T1- and T2-weighted sequences, with a triangular shape on axial images; a defect in the adjacent thyroid cartilage may be visible |
| Arytenoid adduction (adduction arytenopexy) | To enhance posterior glottal closure in patients with paralytic dysphonia by reproducing lateral cricoarytenoid muscle function; can be performed in conjunction with medialization laryngoplasty | The inner perichondrium of the thyroid cartilage is opened and the muscular process of the arytenoid is identified and sutured to the thyroid or cricoid cartilage | Medially rotated (adducted) arytenoid cartilage and narrowing of the posterior glottic gap |