Anesthesia for Vocal Fold Injection

Office-based vocal fold injections under local anesthesia are frequently performed. Visual guide under laryngoscopy provides precise injection to proper site. The video laryngoscope is passed through the mouth or the nose of the patient. For preventing gag reflex by laryngoscopy and providing more comfortable procedure, anesthesia should be provided to nasal cavity, pharynx, and larynx. Topical lidocaine is most widely used medication on office-based procedure. Lidocaine has short onset time, sufficient duration of action, and wide safety margin of dosage. The amount of topical and local anesthetics used in injection laryngoplasty rarely exceeds toxic doses, it may cause discomfort, pain, stinging sensation, nausea, unpleasant taste, globus sensation, dysphasia, or dyspnea. The physician should know proper anesthesia techniques and must be familiar with the safe dose and complication of all anesthetics used.