Securing injection laryngoplasty with anti-reflux valve

Abstract

Background: Injection laryngoplasty (IL) is a common procedure performed by the laryngologist to treat glottal insufficiency. It can be performed under general anaesthesia (GA) or as an office-based procedure. One of the common problems faced during IL is the disconnection between the injection needle and injection material syringe due to high-pressure effect. This may lead to leakage of the injectates especially when injecting high-viscosity materials such as calcium hydroxylapatite (CaHa) or injecting through hard fibrotic scar of the vocal fold.

Purpose: Due to this recurring issue, we propose anti-reflux valve as a connector to link up these two devices. The function of anti-reflux valve is to ensure secure connection between these two devices and overcome the problem.

Methods: The anti-reflux valve that can be used is NeutraClearTM needle-free connector EL-NC1000 or MicroClaveTM clear connector. In our practice, these anti-reflux valves are used together with Integra MicroFrance straight malleable injection needle (0.5 mm diameter, 250 mm length) for IL under GA. However, any other injection needle suitable for IL may also be used with these anti-reflux valves.

Results: Our 3 years' experience has shown good outcome with no reported incidence of device detachment or leakage of injectates during IL procedure.

Conclusions: Anti-reflux valve is a readily available device in the operating theatre or clinic and only involve simple preparation prior to IL. It is beneficial as an added device in IL procedure.

Keywords: Anti-reflux valve; Glottal insufficiency; Injection laryngoplasty; Laryngoscopy.