Clin Exp Otorhinolaryngol.  2019 Nov;12(4):427-432. 10.21053/ceo.2019.00444.

Early Injection Laryngoplasty With a Long-Lasting Material in Patients With Potentially Recoverable Unilateral Vocal Fold Paralysis

• Choi N
• Jin H
• Kim HJ
• Son YI

• KMID: 2462740
• DOI: http://doi.org/10.21053/ceo.2019.00444

Abstract

OBJECTIVES
Injection laryngoplasty (IL) is one of the major options for treatment of unilateral vocal fold paralysis (UVFP). Early IL in patients with abrupt-onset UVFP can reduce hoarseness and aspiration-related discomfort and complications. Temporary or short-lasting materials are recommended for the early IL since permanent or long-lasting materials may negatively affect the voice quality when vocal fold motion is spontaneously recovered.
METHODS
Patients who received IL with a long-lasting material (ArteSense) within 1 month following development of postoperative UVFP were enrolled for this study. They were categorized into a spontaneously recovered group (n=30) and unrecovered group (n=276) from UVFP. The subjective and objective voice parameters were collected before and 6 months after IL. Patients' demographics and collected voice parameters were compared between the two groups.
RESULTS
Age and sex distributions were not different between the two groups. Aspiration symptom, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), overall grade (G) and breathiness (B) of GRBAS (grade of dysphonia, roughness, breathiness, asthenia, strain) scale score, and voice handicap index (VHI) were significantly improved after IL in both groups. The amounts of improvement in MPT, jitter, shimmer, NHR and VHI were significantly greater in the recovered group. There was no IL-related complication including granuloma formation, hypersensitivity to injection material, or worsening of hoarseness.
CONCLUSION
Early IL with a long-lasting material can be safely performed to improve voice quality and to reduce aspiration episode for the patients with postoperative UVFP, regardless of recovery from the paralysis. The amounts of improvement in the subjective and objective voice parameters were significantly greater in patients who showed spontaneous recovery from UVFP when compared with those in patients who did not.

Keyword

Vocal Cords; Paralysis; Laryngoplasty; Early Intervention; Injection

MeSH Terms

Asthenia
Demography
Dysphonia
Early Intervention (Education)
Granuloma
Hoarseness
Humans
Hypersensitivity
Laryngoplasty*
Noise
Paralysis*
Phonation
Sex Distribution
Vocal Cords*
Voice
Voice Quality

Figure

• 

  Fig. 1. Voice parameters before and after injection laryngoplasty in each patient (n=30) of spontaneous recovery from unilateral vocal fold paralysis. MPT, maximum phonation time; VHI, voice handicap index; NHR, noise to harmonic ratio.

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