Results with collagen injection into the vocal folds for medialization.

PURPOSE OF REVIEW: This review outlines the indications, surgical techniques and follow-up, with results, for current collagen use. RECENT FINDINGS: Micronized AlloDerm (Cymetra) is a presently available injectable substance made from human collagen and elastin particles. A mean follow-up of 8-10.5 months showed lasting results after injection for vocal fold immobility. Collagen injection is one possible method for treating a vocal fold scar - or sulcus -vergeture by medialization of one or both of the scarred vocal folds. Collagen injection laryngoplasty is presently the treatment of choice for presbyphonia if speech therapy is insufficient. Collagen injection for Parkinson-related dysphonia is an effective temporary method of subjectively improving voice and speech in selected patients. Laryngeal collagen injection can also permit further medialization of one or both vocal folds after medialization thyroplasty. SUMMARY: Injection laryngoplasty with micronized AlloDerm, a presently available homologous collagen, remains a suitable option for the treatment of vocal fold immobility with a moderate gap. Collagen injection is also efficient for sulcus vergetures, scars and presbyphonia, and can help in cases of Parkinson's disease. Complications are uncommon but patients must be advised that the stability of results is unpredictable. Collagen injection can be repeated and does not prevent other surgical solutions.