Hee Young Son1, Sanghoon Kim2, Ramla Talib Mohammad3, Gene Huh3, Hyojin Kim4, Woo-Jin Jeong3, Wonjae Cha3. 1. Department of Otorhinolaryngology-Head and Neck Surgery, The Dongnam Institute of Radiological & Medical Sciences (DIRAMS) , Busan, Korea. 2. Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. 4. Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Abstract
Purpose: The trans-cutaneous approach is a good option for office-based vocal fold injection (VFI). However, precise localization requires a high level of experience because the needle tip is invisible in small and complex laryngeal spaces. Recently, a new technique, real-time light-guided VFI (RL-VFI), was proposed; it allows simultaneous injection under precise needle localization by light guidance. Herein, we aimed to verify the feasibility of RL-VFI in an in vivo canine model and tried to explore its clinical usefulness. Methods: The device for RL-VFI comprised the light source (light-emitting diode modules [10W] of red color [650nm]) and the injectors (1.5 inches, 23 gauge). An adult male beagle was used for the experiment. After tracheostomy, a rigid laryngoscope was inserted and suspended to expose the larynx. A flexible naso-laryngoscopy system was used to visualize the vocal folds. Results: RL-VFI was performed using various trans-cutaneous approaches, including cricothyroid (CT), trans-thyroid (TT), and trans-hyoid (TH) approaches. Light guidance helped identify the path of the needle and prevent inadvertent penetration. The location of the needle tip was accurately indicated by the light. The lighted needle could be easily placed at the intended points in the vocal fold with real-time visual-motor feedback. Hyaluronic acid could be simultaneously injected lateral to the vocal process under light guidance without manipulation of the device. Conclusion: RL-VFI is safe and feasible in an in vivo canine model, providing precise localization and visual-motor feedback. The clinical application of RL-VFI is expected to improve safety and precision in VFI.
Purpose: The trans-cutaneous approach is a good option for office-based vocal fold injection (VFI). However, precise localization requires a high level of experience because the needle tip is invisible in small and complex laryngeal spaces. Recently, a new technique, real-time light-guided VFI (RL-VFI), was proposed; it allows simultaneous injection under precise needle localization by light guidance. Herein, we aimed to verify the feasibility of RL-VFI in an in vivo canine model and tried to explore its clinical usefulness. Methods: The device for RL-VFI comprised the light source (light-emitting diode modules [10W] of red color [650nm]) and the injectors (1.5 inches, 23 gauge). An adult male beagle was used for the experiment. After tracheostomy, a rigid laryngoscope was inserted and suspended to expose the larynx. A flexible naso-laryngoscopy system was used to visualize the vocal folds. Results: RL-VFI was performed using various trans-cutaneous approaches, including cricothyroid (CT), trans-thyroid (TT), and trans-hyoid (TH) approaches. Light guidance helped identify the path of the needle and prevent inadvertent penetration. The location of the needle tip was accurately indicated by the light. The lighted needle could be easily placed at the intended points in the vocal fold with real-time visual-motor feedback. Hyaluronic acid could be simultaneously injected lateral to the vocal process under light guidance without manipulation of the device. Conclusion: RL-VFI is safe and feasible in an in vivo canine model, providing precise localization and visual-motor feedback. The clinical application of RL-VFI is expected to improve safety and precision in VFI.
Entities:
Keywords:
in vivo animal study; real-time light-guided vocal fold injection; trans-cutaneous approach; vocal fold injection; vocal fold paralysis