Platelet Rich Plasma (PRP) Treatment in Recalcitrant, Bilateral Phono-traumatic Lesions

Abstract

ObjectiveMature vocal fold nodules and fibrous phono-traumatic lesions that have failed standard voice therapy can be challenging. Autologous Platelet-rich plasma (PRP) is rich in growth factors and easily obtained from a simple blood draw. Growth factor injection into the vocal folds may reverse the scar and inflammation in recalcitrant, bilateral phono-traumatic lesions such as mature vocal fold nodules. This study reports the short-term (3 months) voice results after PRP injection in 11 subjects with recalcitrant, bilateral phono-traumatic lesions that have failed voice therapy. Materials and MethodsSerial autologous PRP injections were used to treat eleven patients with recalcitrant, bilateral phono-traumatic lesions in an office setting. All had prior conservative voice therapy or surgery and were deemed failures. Pre and post-treatment video stroboscopy, Voice Handicap Index (VHI-10), and Cepstral Spectral Index of Dysphonia (CSID) before and after treatment (3 months) were tabulated and compared. An expert rater blinded to the treatment condition rated the stroboscopy and voice results. ResultsAt three months post injection, nine of the eleven patients reported improved VHI-10 and noted sustained voice improvement after PRP injections. Median VHI-10 changed from 20 to 13 (p<.05 paired t-test). The CSID scores changed from 17 to 5 (NS p>.05, paired t-test). Nine of eleven patients reported improved vocal effort and stamina. Stroboscopy ratings were better after treatment than before treatment in 7 of the 11 subjects. ConclusionShort-term improvements in voice may occur in patients with recalcitrant, bilateral phono-traumatic lesions following PRP injection. PRP injections into the vocal folds may be a new treatment for non-surgical intervention in patients with recalcitrant, bilateral phono-traumatic lesions. Level of EvidenceII