Question: A patient is referred to you for unilateral vocal fold immobility related to a previous thyroidectomy surgery. You perform vocal fold augmentation with Cymetra and achieve good bulk with intentional overcorrection. She returns to see you 6 weeks later and is disappointed with her vocal quality, saying that she sounds raspy. In-office laryngoscopy shows good bulk of the vocal fold but stroboscopy demonstrates an abnormal mucosal wave. Into what layer of the vocal fold was the injection likely delivered? [Answer will be posted with next week's new question]
Answer to last week's question, PENTOCLO...Say What...?! (September 7, 2015):
The PENTOCLO protocol (pentoxifylline-tocopherol-clodronate) has shown significant promise in the medical management of mandibular osteoradionecrosis, evidenced by decreased mucosal ulceration and, in some cases, radiographic evidence of bone healing. Antibiotics and steroids are also useful in controlling local infection and inflammation.