Advice after your nerve block for surgery
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You have been advised that an injection into one of your vocal folds will be helpful for your voice. These injections may be offered when one vocal fold is not moving properly and as a result, your vocal folds cannot close normally to produce a clear voice.
You may also be experiencing difficulties swallowing. The injection aims to move the vocal fold which doesn’t work, nearer to the one which does, therefore closing the gap between them when you speak. This is done using a filler paste and is called a medialisation procedure.
The following advice is to help you plan for the procedure and get the best result afterwards.
How is the injection given?
The medialisation procedure is carried out in the ENT outpatient department. Before you have the injection, we will ask you to perform a number of voice tasks so we can assess your voice.
For the injection you will be asked to lie down on a couch. A local anaesthetic will be sprayed into your nose and then a nasendoscope will be passed through your nose.
This is done in the same way it was when we looked at your vocal folds in clinic. Another local anaesthetic will then be injected into the front of your neck to numb the area. A second injection takes place to put the filler material into your vocal fold. The actual injection only takes about five minutes.
Are there any risks?
The risks of this procedure are very low and will be explained to you when you give your consent. You may experience some stinging from the local anaesthetic which will soon pass; some discomfort during the procedure and also referred pain to your ear.
Before your injection
- Avoid smoking and drinking alcohol and if you have been prescribed reflux medication make sure you take it regularly
- Plan to have voice rest after your injection i.e. warn your friends and family that you will not be able to speak for two days
- Have a pad and pen available to write things down
- Inhale plain steam at least once, but preferably twice a day.
On the morning of the injection you can eat and drink normally. It is best to eat a light breakfast/lunch, so that you are not feeling hungry when you have the procedure. If you can, bring someone with you on the day for support. If you normally drive yourself, you may drive home as long as you are feeling well.
After the injection
- We will ask you to test your voice by saying ‘eee’ but after this you must rest your voice completely for two days. Don’t speak, whisper, laugh or throat clear if you can possibly help it.
- You will be asked to wait in the reception area for 20-30 minutes. During this time do not have anything to eat or drink. It is best to wait until the anaesthetic has worn off before drinking; this can take up to an hour
- After this time and once you can feel yourself swallowing normally, drink plenty of fluids. It is generally best to avoid caffeinated or alcoholic drinks, which dry out your vocal folds
- You may cough a little at first and there may be specks of blood, this is normal and nothing to be alarmed by
- Avoid smoke or smoking
- Do not answer the telephone during the first 48 hours; ask people to send you text messages instead.
After the first two days
- Aim to speak at a normal conversational level, and rest your voice if it feels tired
- Avoid shouting, throat clearing, coughing and whispering
- It is a good idea to keep phone conversations short until you have got used to your new voice
- Try to have short periods of voice rest between speaking
- Keep drinking plenty of fluids, preferably water
- Continue inhaling steam.
You will be offered an appointment to see a speech and language therapist two weeks after your injection.
You will normally be sent an appointment to come back to the voice clinic six weeks after your injection to see how your voice has settled.
Contact us
If you have any queries relating to this information, please contact the Speech and language therapy service.
About this information
Service:
Speech and language therapy
Reference:
VV/045
Approval date:
27 September 2024
Review date:
1 September 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.