Background: Unresolved vocal fold palsy affects a person’s ability to communicate effectively and negatively impacts quality of life. Individuals often report frustration, change in self-identity and limiting participation in social activities. Perceptual voice characteristics present in the unilateral vocal fold palsy population include asthenia, roughness, breathiness, lack of resonance and reduced volume frequently giving rise to other maladaptive vocal behaviours such as muscle tension dysphonia. Awake injection medialisation in a clinical setting is a timely, safe, well tolerated, and is a cost-effective treatment. Temporary, dissolvable filler is injected into the affected vocal fold to improve glottic closure and subsequent voicing. A novel joint laryngology, speech pathology in chair medialisation clinic was established at Fiona Stanley Hospital in 2021.

Objectives: To complete a service delivery evaluation including pre and post medialisation impairment, quality of life and satisfaction related outcomes.

Method: A retrospective audit was conducted from data captured pre and post medialisation between 2021-2023. Variables charted included patient related demographics, impairment and quality of life outcomes and service-related measures including frequency and timing between medialisations and amount of filler used. Patient satisfaction and service acceptability was determined via questionnaires and semi structured interviews. Data was analysed using thematic analysis.

Results: To date, 40 patients have received in chair medialisation with 29 patients having completed follow up assessment. Preliminary results reveal improved voice and quality of life outcomes for 24 patients (82%) with an average satisfaction score of 80/100. There was no deterioration in measures for 5 patients (17%). Data analysis is ongoing and final results including thematic analysis will be presented.

Conclusion: This evaluation demonstrates that a novel multidisciplinary in chair medialisation clinic for vocal fold palsy is beneficial and feasible in an outpatient care setting.

1. In chair medialisation for unilateral vocal fold palsy is cost-effective, timely and yields immediate results with improvements to voice and quality of life outcomes.
2. Service delivery is multidisciplinary and requires a specialist laryngologist and highly skilled speech pathologist to complete the procedure in an outpatient setting.
3. Patients were satisfied with an awake percutaneous approach for injection delivery.