J Korean Soc Laryngol Phoniatr Logoped.  2018 Jun;29(1):30-36. 10.0000/jkslpl.2018.29.1.30.

Benefits of Palliative Office-Based Hyaluronic Acid Injection Laryngoplasty in Cancer-Related Unilateral Vocal Cord Paralysis Patients

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. hnsdi@catholic.ac.kr
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Otolaryngology, Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.

Abstract

BACKGROUND AND OBJECTIVES
The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. MATERIALS AND METHOD: 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life.
RESULTS
In GRBAS scale, G (p < 0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p < 0.001, p < 0.001 p=0.003, p < 0.001, and p < 0.001 respectively).
CONCLUSION
From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

Keyword

Palliative injection laryngoplasty; Hyaluronic acid; Cancer-related unilateral vocal cord paralysis; Voice function; Swallowing function; Quality of life

MeSH Terms

Acoustics
Deglutition
Enteral Nutrition
Humans
Hyaluronic Acid*
Laryngoplasty*
Methods
Palliative Care
Phonation
Pneumonia, Aspiration
Quality of Life
Vocal Cord Paralysis*
Voice
Voice Quality
Hyaluronic Acid
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