Prospective study of voice outcomes and patient tolerance of in‐office percutaneous injection laryngoplasty

Abstract

In-office percutaneous injection laryngoplasty is a common treatment for glottal insufficiency. Our objective was to prospectively study voice outcomes and patient tolerance of the procedure. Prospective case series. Consecutive adult patients undergoing awake injection laryngoplasty were recruited. Voice Handicap Index (VHI)-30; Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V); and vocal Grade, Roughness, Breathiness, Asthenia and Strain (GRBAS) were evaluated prior to injection and 2 months postinjection. Visual analog scale (VAS) was completed by the patient before and after the procedure to quantify the amount of discomfort. Thirty-five subjects enrolled; 26 (15 male, 11 female; mean age 61.6 ± 13.2 years) had complete data. All components of VHI improved significantly: functional (P=0.0006), emotional (P=0.0004), physical (P=0.009), and total (P=0.0006). CAPE-V also improved significantly (P=0.003). All components of GRBAS, except for roughness, improved significantly: grade (P=0.004), roughness (P=0.718), breathiness (P=0.023), asthenia (P=0.023), and strain (P=0.03). Patient expectations on the tolerance of the procedure was similar to what they reported immediately afterward (P=0.803). Injection laryngoplasty is an effective method of treating glottal insufficiency, as measured by voice outcomes. Patients have realistic expectations on the procedure experience and find it tolerable. This is the first prospective study of injection laryngoplasty outcomes.