Endoscopic injection augmentation
Method
Endoscopic injection augmentation is usually performed under general anesthesia with an open airway and spontaneous breathing. After inserting a laryngoscope to expose the cleft, the ENT injects an absorbable filler into the edges and bottom of the cleft to bulk up the tissue. A variety of filler agents exist and include carboxymethylcellulose, autologous fat, hyaluronic acid, and absorbable gelatin sponge.
Hospital stay
Patients typically stay in the hospital overnight depending on their recovery, bed availability, and hospital practices. Follow-up testing varies. If the injection lessens symptoms, some ENTs will move on to a suture repair, while others may offer repeat injections.
Longevity
Injection augmentation is considered a temporary treatment, though a few ENTs have reported a small minority of patients that have experienced long-term improvements.
Cleft type: 1
Advantages:
Temporary aspiration improvement for some patients
Can be done at time of diagnosis
Not technically challenging
May predict future suture repair effectiveness
Relatively quick and minimally-invasive surgery
Well-tolerated by most children
Disadvantages:
Lasts one to three months
May not improve symptoms
Requires general anesthesia
Can cause scarring
Filler may migrate into other parts of the larynx
May not correctly predict future suture repair effectiveness
Other complications and risks exist