Voice Lift Procedure (Radiesse/Restylane Injection)

For ageing voice and vocal fold paralysis/weakness.

Trial Injection Medialisation (Restylane or Radiesse)

We normally try to medialise the vocal fold with a substance that is easily absorbed if the paralysis is likely to recover.

Hyaluronic acid is present naturally within the body’s soft tissue such as vocal folds and is often used as a filling agent for ladies facial cosmetics in cheeks and lips. It is present in various forms depending on length of time required.

These substances are safe because they are eventually absorbed and vary depending what length of time is required.

Restylane (hyaluronic acid) = about 6 months.

Perlane (larger molecules of hyaluronic acid) = about 10-12 months.

Radiesse or Hydroxyapatite is the latest injection treatment used in voice lift procedures as it lasts up to a year.

Injection Medialisation Laryngoplasty or “Voice Lift” Procedures

For an effective voice the vocal folds must meet each other in the midline.

If one vocal fold is thinned out, bowed or paralysed AND if no recovery occurs, the only way to produce a voice is to push the weak one inwards. This is known as “medialisation”. In some cases only the floppy membranous part of the cord needs to be corrected — usually by an implant or INJECTION.

Many years ago Teflon paste was injected into the vocal fold. The problem was that it often went into the wrong place, either too near the surface or too deep (Subglottic). It is very hard to get out. Silicone, although effective has the same risk.

It should be emphasized that injection laryngoplasty will not close very large gaps or the back of the voice box (Inter- Arytenoid area).

Approach

THE filling agent – Restylane or Radiesse can be inserted under a general anaesthetic for accurate placement straight into the paralysed vocal fold or it can be inserted through the skin of the neck with local anaesthetic.

The latter avoids an anaesthetic and works in 90% but is not quite as accurate.