Injection laryngoplasty was introduced by Bruning in 1911, more than a century ago, but it does not look so old. Indeed, despite having had phases of varying fortune mainly linked to the characteristics of the materials available, since injection laryngoplasty (IL) was introduced it was never abandoned and still has many supporters despite the competition of the structural surgery and laryngeal reinnervation. In fact, IL is a technique that does not require an external approach and is able to solve important voice problems, often related to accidental or inevitable consequence of cervical and thoracic surgical procedures.

IL is a procedure that in some situations and with certain materials can be carried out under local anesthesia and mild sedation by fiberendoscopy or by transcutaneous access under endoscopic vision. This procedure is minimally invasive and very fast even when it is performed by means of microlaryngoscopy under general anesthesia. For these reasons IL is generally accepted even by those patients who have suffered iatrogenic damage and are reluctant to face further surgical procedures.

The main indication for injection laryngoplasty is unilateral vocal fold paralysis, but it also finds application in atrophy and cordal scars. Beyond the purpose of vocal fold filling that justifies the definition of “laryngoplasty,” IL is also used for infiltration of drugs into the vocal cords (botulinum toxin, corticosteroids, growth factors, etc.).

This technique, after the initial experience of Bruning, was revisited many years later (1945) by Arnold, [1] but a new and decisive impulse came when Ford [2] in 1986 proposed clinical use of bovine collagen after a preliminary study on dogs. He designed also an injection kit that is still available and it can be used also with other materials. Since then many materials have been introduced with characteristics of high biocompatibility and persistency of variable duration at the injection site.