Conclusion: Injection augmentation with CaHA is an exciting new addition to the laryngologist's therapeutic armamentarium in the treatment of glottal insufficiency. The implant is safe, efficacious, and initial experience suggests that it is extremely durable. Vocal fold augmentation with Radiesse can be performed in the office under local anesthesia or in the operating room under general anesthesia. Because we are uncertain about the adverse effects of inaccurate CaHA injections, we prefer to perform the procedure in the operating room under microscopic guidance where precision can be guaranteed.
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