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December 1988

Nerve Transfer vs Polytef Injection for Vocal Cord Paralysis

Arch Otolaryngol Head Neck Surg. 1988;114(12):1363. doi:10.1001/archotol.1988.01860240013001

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Dr Roger Crumley, San Francisco, at the annual meeting of the Triological Society in Palm Beach, Fla, presented an update on his results with nerve transfer in the treatment of vocal cord paralysis. His technique involves anastomosis of the nerve to the sternohyoid muscle to the recurrent laryngeal nerve, distal to the site of injury. Gelfoam injection is performed to provide vocal improvement during the time required for reinnervation.

Results were presented for five patients, documented by sonography and, in some cases, videolaryngostroboscopy. The goal of the procedure is not normal movement but resting tone in the vocalis muscle, which permits more normal vibration of the vocal fold. Dr Crumley feels that the results of this procedure are much more reliable than those of polytef (Teflon) injection. Complications of polytef injection that he cited included granuloma formation and migration of the polytef. Dr Crumley states that there are few perfect

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