Abstract

PurposeThe objective was to investigate whether a patient’s preoperative test results can predict the need for future reoperation in unilateral vocal fold paralysis (UVFP).MethodsA single-centre retrospective study was performed. The study group consisted of 18 patients with UVFP who had been treated with injection laryngoplasty but who required further treatment and were augmentated again within 36 months. The control group consisted of 33 injected patients who had not required reintervention up to 36 months later.ResultsOnly glottal gap was associated with a relative risk for reinjection. Glottal gap was found to be severe in 77.8% of the patients from the study group compared to 42.4% of the controls, and the difference was statistically significant. The kind of injected material (calcium hydroxylapatite or hyaluronic acid), age, and voice assessment (perceptual, objective, or subjective) did not seem to affect the likelihood of reoperation being needed. There were no between-group statistically significant differences in individual aspects of the GRBAS scale. The global score was slightly higher in the study group, but it did not reach statistical significance (U = 198.5; p = 0.09). A comparison of VHI scores did not yield statistically significant differences between the study and control groups. No significant differences in objective acoustic voice parameters were observed between the groups.ConclusionOnly glottal gap occurred to be associated with a relative risk for reinjection. A kind of injected material (CaHA or HA), age, perceptual, objective and subjective voice assessment do not seem to impact the likelihood of reoperation in patients with UVFP.

Highlights

  • Unilateral vocal fold paralysis (UVFP) occurs in approximately 0.41–0.51% of the population, with voice deterioration present in 83.6% of cases [1]

  • The consequences of unilateral vocal fold paralysis (UVFP) are significant functional deficits manifesting as dysphonia, with a breathy, weak voice resulting from glottal insufficiency, dysphagia, or aspiration

  • The inclusion criteria were as follows: patients over 18 years old, having glottal insufficiency and/or dysphonia due to UVFP, having had an injection laryngoplasty (IL) procedure during which the paralysed vocal fold was injected with either calcium hydroxylapatite (CaHA) and/or hyaluronic acid (HA), and available to fill out a voice quality questionnaire

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Summary

Introduction

Unilateral vocal fold paralysis (UVFP) occurs in approximately 0.41–0.51% of the population, with voice deterioration present in 83.6% of cases [1]. UVFP results from unilateral injury of the vagus nerve or the recurrent laryngeal nerve, mostly due to surgery (47–56%) or idiopathically (12–37%) [2]. Treatment for UVFP focuses mainly on restoration of the voice by decreasing the glottal gap and recovering a mucosal wave, and includes voice therapy and surgery. A wide variety of surgical interventions are currently available for treatment of nonresolving UVFP, including injection laryngoplasty (IL), medialization thyroplasty, arytenoid adduction, and reinnervation. Injection laryngoplasty, introduced by Brunings in 1911, is a minimally invasive technique that, over decades, has proven its effectiveness in restoring the voice in UVFP.

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