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Ear, Nose, and Throat Disorders

Use of Radiesse for repair of vocal cord

12/10/2009

Question:

My mother had knee replacement surgery 7 months ago. After surgery she had trouble speaking, her voice was very raspy and she had a severe sore throat for about 3-4 days afterwards. Now she has seen a throat specialist who is recommending using Radiesse injection to correct the vocal damage by "fluffing it up". I can`t find any info on the use of this drug for this purpose, is it safe? Can you please help?

Answer:

Yes Radiesse is safe, but there are a few things to ask about:

1. Has she had a videostroboscopy. This will tell you how well the lining of the cord is vibrating. The test involves putting a scope in her throat while she is awake and using a strobe light. The problem with her voice may be that there is a gap (a hole between the vocal cords when she talks - this gives a soft, breathy voice) or her lining could be inflamed. The strobe helps differentiate.

2. There are 2 different types of Radiesse used for the larynx. The first is Radiesse Voice and the second is Radiesse voice gel. The first is much stiffer and cannot be injected near the vibrating, pliable lining. It will also last a lot longer (8 months and longer are usually reported). It has shown complications - scarred or fibrous masses can form in the cord and cause significant damage. This complication is uncommon but definitely happens. The stiffness comes from small calcium hydroxyapetite crystals in it. The second is Radiesse Voice Gel. It does not have calcium hydroxyapetite in it, and is much less stiff. Also, it goes away in 2-4 months. I use the gel and have no problems with it. I think (and the literature supports this) that it is very safe. 

Your mother's problem can be temporary or permanent. A small gap is seen in many normal elderly patients.  There are also many reasons for injection. I would find out if this is being injected for a gap, or for vocal cord paralysis. For either of these, only temporary treatment is necessary. I would need much more information to address that topic.

So Radiesse Voice Gel is safe, but I would not use the non-gel (i.e. just Radiesse voice) unless the side effects are understood. And I would make sure a strobe was done to confirm that this is the right procedure. Let me know if you have any questions.

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Response by:

Siddarth M Khosla, MD Siddarth M Khosla, MD
Assistant Professor
College of Medicine
University of Cincinnati