Transcutaneous Teflon injection for paralytic dysphonia.

Transcutaneous Teflon augmentation of the vocal cord was performed 21 times in 19 patients with unilateral vocal cord paralysis. The larynx was visualized using flexible fiberoptic video-endoscopy and, after local anesthesia to the skin over the cricothyroid membrane, an 18-gauge 2-inch needle was introduced through the cricothyroid membrane. Under fiberoptic visualization, the needle was inserted into the paralyzed vocal cord through its undersurface. Teflon was injected with a syringe to produce medialization of the vocal cord. The position of the vocal cord and voice quality were monitored throughout the procedure. No complications were encountered. All patients experienced a reduction in breathiness of voice that was rated as a significant improvement by the patient and surgeon. Two patients required reinjection of Teflon for optimal improvement.