Technical Description:
6 patients were treated over the last year using this method. General anaesthesia was given to these patients and they were ventilated through an armoured tube inserted through the laryngeal stoma. Patients were positioned with their neck flexed and head extended, though the extension was limited in these patients due to post-radiotherapy fibrosis. A GlideScope was inserted through the oral cavity along the tongue and the top of the scope was used to lift the base of the tongue (figure 1). This provided a good view of the neopharynx in all the cases. Botox was kept ready pre-loaded on a syringe with a 22-gauge needle. The needle was inserted through the neck and under the direct vision of the GlideScope, Botox was injected into the PE segment/posterior pharyngeal wall at the level of the neopharynx down to the level of the valve (figure 2). It was feasible to inject Botox in all the patients using this technique and in none of them did we have to resort to any other technique. All of them had improvements in their voice outcomes.