Outcome of regenerative therapy for age-related vocal fold atrophy with basic fibroblast growth factor

Abstract

Objectives/hypothesis: Age-related vocal fold atrophy has become a significant voice disorder as the elderly population grows. However, several therapeutic challenges have limited attempts to improve voice quality. We reported that basic fibroblast growth factor (bFGF) stimulates fibroblasts to produce extracellular matrices such as hyaluronic acid in the lamina propria, leading to a regeneration of pliable vocal folds in animal models. The aim of this study was to determine the efficacy of bFGF for the treatment of age-related vocal fold atrophy.

Study design: Prospective study.

Methods: Six patients with age-related vocal fold atrophy underwent injection of bFGF in their vocal folds. Vocal outcomes and stroboscopic examinations were evaluated 1, 3, and 6 months after the injection. The outcome measures included the Voice Handicap Index-10 (VHI-10), GRBAS (grade, roughness, breathiness, asthenia, strain) scale, maximum phonation time (MPT), the amplitude perturbation quotient (APQ), and the pitch perturbation quotient (PPQ).

Results: The VHI-10 was significantly improved 6 months after bFGF injection. The GRBAS scale, MPT, APQ, and PPQ were also improved. Stroboscopic examinations showed significant improvement of glottic closure and better mucosal wave.

Conclusions: This is the first study to evaluate the regenerative effects of bFGF injection for the treatment of age-related vocal fold atrophy using the VHI-10. Injection of bFGF significantly improved VHI-10 scores and glottal insufficiency for at least 6 months.

Level of evidence: 4. Laryngoscope, 126:1844-1848, 2016.

Keywords: Basic fibroblast growth factor; Voice Handicap Index-10; aging; vocal fold atrophy.