Abstract
BackgroundInjection laryngoplasty is a surgical procedure used in management of glottal insufficiency. The objective of this study was to assess respiratory and voice outcomes of office-based injection laryngoplasty in patients with unilateral vocal fold paralysis (UVFP). Ten patients underwent office-based injection via transcutaneous approach using Radiesse or hyaluronic acid. Auditory perceptual assessment (APA), voice handicap index (VHI), size of the glottic gap, acoustic parameters (jitter, shimmer, and harmonic to noise ratio), maximum phonation time (MPT), stroboscopic evaluation, pulmonary function tests (PFTs), and videofluoroscopic evaluation of swallowing were done pre-injection, 1 week and 3 months post-injection.ResultsSubjective and objective voice outcomes, in addition to laryngostroboscopic parameters improved after injection. Non-significant difference was found between pre- and post-injection results of the PFTs.ConclusionsOffice-based injection laryngoplasty is a safe and effective method for treating UVFP. Patients with glottic gap (< 1–3 mm) are perfect candidates for such procedure. Injection laryngoplasty improves patients’ voice quality and does not impair respiration.
Highlights
Injection laryngoplasty is a surgical procedure used in management of glottal insufficiency
Vocal fold paralysis (VFP) refers to vocal fold (VF) immobility caused by neurologic injury [1]
The etiology of unilateral vocal fold paralysis (UVFP) includes malfunction of the nuclei of the brainstem, the 10th cranial nerve, or the recurrent laryngeal nerve that supplies the corresponding side of the larynx
Summary
Injection laryngoplasty is a surgical procedure used in management of glottal insufficiency. The objective of this study was to assess respiratory and voice outcomes of office-based injection laryngoplasty in patients with unilateral vocal fold paralysis (UVFP). Ten patients underwent office-based injection via transcutaneous approach using Radiesse or hyaluronic acid. Auditory perceptual assessment (APA), voice handicap index (VHI), size of the glottic gap, acoustic parameters (jitter, shimmer, and harmonic to noise ratio), maximum phonation time (MPT), stroboscopic evaluation, pulmonary function tests (PFTs), and videofluoroscopic evaluation of swallowing were done pre-injection, 1 week and 3 months post-injection. The etiology of unilateral vocal fold paralysis (UVFP) includes malfunction of the nuclei of the brainstem, the 10th cranial nerve (vagus), or the recurrent laryngeal nerve that supplies the corresponding side of the larynx. Many neck and thoracic surgeries might be complicated by UVFP. Another common etiology of UVFP is non-laryngeal malignancies (e.g., bronchogenic carcinoma) [2]. The abducted VF in UVFP will affect the quality of voice resulting in breathiness, diplophonia, reduced loudness, decreased phonation time, and a restricted
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