Introduction
Glottal insufficiency is characterized by incomplete closure of the vocal cords when phonating, which causes inappropriate leakage of air through the glottis on attempting to phonate and there is an increased risk of aspiration. Unilateral vocal cord paralysis is the most common cause ofincomplete glottal closure. Injection laryngoplasty or vocal cord augmentation involves injection of various materials into the lateral aspect of the vocal cord. In this study we are using hyaluronic acid in injecting vocal cord under general anaesthesia.

AIM OF THE WORK
This study aims to show the voice outcomes of vocal cord augmentation
with hyaluronic acid under general anaesthesia in patients with glottal insufficiency.

PATIENTS AND METHODS
The study was carried on twenty patients having glottal insufficiency attending the outpatient clinic, at Otorhinolaryngology Department, Alexandria Main University Hospital, Alexandria, Egypt.

Each patient was subjected to full history taking, full ENT examination, video laryngoscopic examination for documentation of vocal cords and acoustic analysis of voice in order to assess Jitter, Shimmer and Noise to harmonic ratio. Each patient was assessed preoperatively and followed up at 2 weeks, 1 month & 6 months postoperative.