Dr. Anis featured in the article, Getting his Voice Back


Jersey Shore University Medical Center: When a vocal cord injury silenced a Wall Township man, a minimally invasive injection provided the solution.

Robert Margadonna, 88, loved being social with friends and family. That is, until one of his vocal cords became paralyzed after heart surgery at a hospital in central New Jersey. The effects of the surgery caused the valve in his vocal cord to leak, leaving Robert with a low, breathy voice that was difficult to understand.

“I would sit in my room by myself because I was embarrassed that people couldn’t hear me. I had to constantly repeat myself,” says Robert.

Taking Action

After seeing Robert retreat to his room in his adult living community, his brother Frank and nephew Mark insisted that he go to a doctor to see what could be done to help his throat. Mark did research online and found Mursalin Anis, M.D., Ph.D., a voice specialist with Jersey Shore University Medical Center. Robert’s family brought him to see Dr. Anis for an examination.

“I completed an awake transoral injection without general anesthesia. This procedure was done to ‘bulk up’ the damaged vocal cord, stop the leaky valve, and allow Robert to speak clearer and louder. To some extent, it also improves swallowing and breathing stamina,” says Dr. Anis. “This procedure allows the vocal cords to close completely so that the valve is not leaking anymore.”

Trial Run

The first step in treating Robert was to put a temporary gel-like material, carboxymethyl cellulose, in place to see how his vocal cord would react to the treatment. This injectable lasts for about four weeks and dissolves on its own.

“The beauty of this procedure is that it is minimally invasive, without risk of general anesthesia. And we are able to see how the patient will behave with the injection, so we will know if it worked or not, right away,” says Dr. Anis.

No Longer Silent

Since the gel worked well for Robert, and he was not a candidate for long procedures under anesthesia, Dr. Anis was able to inject a longer-lasting material called calcium hydroxyapatite without using general anesthesia. This is a bonelike material that brought the paralyzed vocal cord closer to the other vocal cord that moves normally. Because of this, the valve made by his vocal cords stopped leaking.

After the procedures, Robert attended both speech and swallow therapy at Jersey Shore. “I’m so happy because I can talk to you. I don’t sit in my room anymore; I can mingle with my friends,” says Robert. “I feel like I got my life back.”

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