Injection laryngoplasty as an effective treatment method for glottal insufficiency in aged patients

Abstract

PurposeThe purpose of the study was to assess outcomes of injection laryngoplasty (IL) for treating glottal insufficiency in elderly patients with presbyphonia or unilateral vocal fold paralysis (UVFP). MethodsA single-center retrospective study was performed. The study group consisted of 34 patients with glottal insufficiency aged between 60 and 82 years who had been treated with injection laryngoplasty. Of them, 16 patients were diagnosed with presbyphonia and 18 with UVFP. ResultsAfter IL, glottal closure improved in both groups. The change was statistically significant in the patients with presbyphonia (marginal homogeneity test MH = 3.80; p < 0.001) and in the UVFP patients (MH = 4.04; p < 0.001). Voice quality improved after IL and 12 months after surgical intervention remained significantly better compared to before augmentation (MH tests were statistically significant at p < 0.05 for R, B, A, and S parameters). In the patients with UVFP, significant improvement was observed in 7 of 12 evaluated parameters (Jitt, RAP, PPQ, Shim, APQ, sAPQ, and NHR) but in the patients with presbyphonia only average fundamental frequency (F0) improved significantly. Comparison of the Voice Handicap Index outcomes before and 12 months after surgery showed improvement of subjectively assessed voice quality in both groups; however, the change was statistically significant only in the UVFP patients. ConclusionsInjection laryngoplasty is a safe and effective treatment method for glottal insufficiency in the elderly. This study shows a significant and clinically relevant improvement to at least12 months, especially in patients with UVFP.