Injection Laryngoplasty: Impact on Swallowing and Aspiration

Abstract

Objective: Vocal fold paralysis (VCP) and glottic insufficiency result in difficulties with dysphonia, dysphagia, and cough strength. This pilot study compares quality of life (QOL) and aspiration in patients with VCP before and after injection laryngoplasty (IL). Methods: A prospective case series at an academic tertiary care hospital on 7 pilot patients (age 64-85 years, mean 71 years) with VCP and symptoms of aspiration. All patients underwent modified barium swallow (MBS) or fiberoptic endoscopic evaluation of swallow (FEES). MBS and FEES studies were evaluated using Penetration-Aspiration scale (PENASP). Additionally, patients completed 2 QOL questionnaires, the EAT-10 and the Voice Handicap Index (VHI). All patients underwent IL with micronized dermis. Four underwent unilateral injection, 3 underwent bilateral injection. Repeat evaluation at 3 months with MBS or FEES was again scored with PENASP scale. Patients again completed the questionnaires. Results: All 7 reported improvement in QOL on VHI ( P = .03). There was no difference in pre and post procedure EAT-10 scores. Two of 7 patients showed decreased aspiration on thin liquid PENASP scores and 5 of 7 patients showed no change ( P = .19). There was no difference in pre and post PENASP scores with semi-solids. Conclusion: This study suggests that IL improves QOL for patients with VCP and that IL may improve aspiration with thin liquids. A prospective case series with a larger sample size is needed to further evaluate the effects of IL on aspiration and quality of life.