Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;71(Suppl 1):960-966.
doi: 10.1007/s12070-019-01642-w. Epub 2019 Apr 8.

Vocal Fold Insufficiency: How Effective is Injection Laryngoplasty? Short Term Clinical Outcomes

S K Singh  1 , Salil Kumar Gupta  2
Affiliations

Vocal Fold Insufficiency: How Effective is Injection Laryngoplasty? Short Term Clinical Outcomes

S K Singh et al. Indian J Otolaryngol Head Neck Surg. 2019 Oct.

Abstract

Office based Injection Laryngoplasty has become a common and feasible method of addressing vocal fold insufficiency (VFI) resulting from a plethora of aetiologies. Contemporary to various injectates, Calcium Hydroxylapatite has met with great success across usage with various techniques. But, irrespective of the technique and injectate material, the burning question in mind of "realistic" clientele remains, "How soon will I have by voice back?". Aim of this study is to evaluate the short term (3 months postoperative) effects of Injection Laryngoplasty in cases of VFI using Calcium Hydroxylapatite via trans cricothyroid route, in terms of both objective and subjective parameters. 12 patients with mean age of 35.67 years underwent vocal fold injections (via transnasal flexible fibreoptic laryngoscopic guided trans-cricothyroid membrane approach using CaHA) for VFI. The pre injection and 1, 2- and 3-months post injection scores' changes in outcome measures in form of videostroboscopic parameters, Voice Handicap Index scores and acoustic analysis were compiled and analysed. 91.6% of patients showed statistically significant benefit after 3 months post injection. 0.1% patients showed loss of benefit of the CaHA material even 3 months post injection. Average length of benefit was 1-month post injection. No significant complication was observed in any patient. We conclude that the objective evidence of structural and functional improvement may be seen immediately post injection laryngoplasty, minimum of 3 months is required for evident improvement in patient's perception of his own voice in terms of Quality of Life parameters.

Keywords: Acoustic analysis; Calcium hydroxylapatite (CaHA); Injection laryngoplasty; Trans-cricothyroid injection augmentation; Videostroboscopy; Vocal fold injection; Vocal fold insufficiency; Voice Handicap Index.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestAll authors declare that they have no conflict of interests.

Figures

Fig. 1
Fig. 1
Trans-cricothyroid membrane approach for Injection laryngoplasty. Transnasal fibreoptic flexible laryngoscopic images. Through images a–d, needle can be seen advancing from left side and bulge of injectate over right true vocal cord
Fig. 2
Fig. 2
Distribution of aetiologies of vocal fold insufficiency
Fig. 3
Fig. 3
Vocal fold symmetry: pre and post-operative assessment
See this image and copyright information in PMC

References

    1. Sulica L, Cultara A, Blitzer A. Vocal fold paralysis: causes, outcomes, and clinical aspects. In: Sulica L, Blitzer A, editors. Vocal fold paralysis. 1. Berlin: Springer; 2006. pp. 33–48.
    1. Rubin AD, Sataloff RT. Vocal fold paresis and paralysis. Otolaryngol Clin N Am. 2007;40(5):1109–1131. doi: 10.1016/j.otc.2007.05.012. - DOI - PubMed
    1. Rosen CA, Thekdi AA. Vocal fold augmentation with injectable calcium hydroxylapatite: short-term results. J Voice. 2004;18(3):387–391. doi: 10.1016/j.jvoice.2004.02.001. - DOI - PubMed
    1. Isshiki N, Morita H, Okamura H, Hiramoto M. Thyroplasty as a new phonosurgical technique. Acta Otolaryngol. 1974;78(1–6):451–457. doi: 10.3109/00016487409126379. - DOI - PubMed
    1. Schneider B, Denk D-M, Bigenzahn W. Acoustic assessment of the voice quality before and after medialization thyroplasty using the titanium vocal fold medialization implant (TVFMI) Otolaryngol Head Neck Surg. 2003;128(6):815–822. doi: 10.1016/S0194-5998(03)00359-0. - DOI - PubMed

LinkOut - more resources