Static Medialization: Fat Injection Versus Medialization Laryngoplasty

There are now many options in the management of unilateral vocal fold paralysis. Once the evaluation is complete, the patient can then be offered conservative management or an intervention. The interventions can range from temporary vocal fold augmentation in the office under local anesthesia to more permanent options such as framework surgery. This chapter will compare and contrast vocal fold injection with autogenous fat and medialization laryngoplasty. While both can be effective, there are multiple factors that must be considered to ensure that the patient has a satisfactory outcome. One component of this is having a discussion with the patient in order to set expectations and to better understand what the patient’s goals are and the level of invasiveness they would be willing to accept. These patient specific factors are often the guiding principle in how to proceed.