The role of growth factors in the treatment of voice disorders: systematic review

Abstract

Objective The aim of this study was to present a review about the role of growth factors (GFs) in the treatment of some voice disorders. Materials and methods The data sources consisted of Medline databases (PubMed, Elsevier, and Wily Library) and all materials available in the internet from 1990 to 2017. The initial search presented 150 articles, of which 57 met the inclusion criteria, with level II-2 as the level of evidence. The articles studied the function, uses and the efficacy of basic fibroblast growth factor (bFGF) on vocal outcomes of patients with vocal fold (VF) lesions. If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria were specified, appropriate controls were used, adequate information was given and whether the studies defined assessment measures. Significant data were collected. It was heterogeneous. Thus, a structured review was performed with the results tabulated. Conclusion VF lesions and paralysis induced severe dysphonia, and the fundamental therapy for these diseases is voice therapy; however, this approach is ineffective for severe dysphonia. Surgical approaches have been attempted, but the outcome varies. The aim of surgical treatment has recently changed to stimulate the regeneration of VF structures. GF therapy is considered to be a 'trigger' for jumpstarting biological processes. One promising GF is bFGF. Cases of severe dysphonia that were treated by the single, transoral bFGF injection method showed significant improvements in the vocal functions after injection. The single injection method is easy to perform as an office procedure. The use of bFGF injection to treat severe VF lesions and VF paralysis is still controversial.