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Clinical Trial
. 2024 Dec;134(12):5021-5027.
doi: 10.1002/lary.31683. Epub 2024 Aug 8.

Prospective Outcomes After Serial Platelet-Rich Plasma (PRP) Injection in Vocal Fold Scar and Sulcus

Chloe Santa Maria  1 , Elizabeth A Shuman  1 , Benjamin Van Der Woerd  2 , Clare Moffatt  3 , Carlos X Castellanos  3 , William Z Gao  4 , Neel K Bhatt  5 , Yael E Bensoussan  6 , Jack Rodman  7 , Kacie La Forest  1 , Felicia Francois  1 , Karla O'Dell  1 , Dinesh K Chhetri  3 , Michael M Johns 3rd  1
Affiliations
Clinical Trial

Prospective Outcomes After Serial Platelet-Rich Plasma (PRP) Injection in Vocal Fold Scar and Sulcus

Chloe Santa Maria et al. Laryngoscope. 2024 Dec.

Abstract

Objective: Vocal fold scar and sulcus pose significant treatment challenges with no current optimal treatment. Platelet-rich plasma (PRP), an autologous concentration of growth factors, holds promise for regenerating the superficial lamina propria. This study aims to evaluate the potential benefits of serial PRP injections on mucosal wave restoration and vocal function.

Methods: In a prospective clinical trial across two institutions, patients with vocal fold scar underwent four serial PRP injections, one month apart. Blinded independent laryngologists and expert listeners used pretreatment and one-month post-fourth injection videostroboscopy and CAPE-V assessments to evaluate mucosal wave and voice quality changes, respectively. Additionally, patient reported outcome measures (PROMs) were evaluated.

Results: In the study, 15 patients received 55 PRP injections without adverse effects. Eight patients (53.3%) had mild, three patients (20%) had moderate, and four patients (26.7%) had severe scar. There was an average reduction of 8.7 points in post-treatment VHI-10 scores (p = 0.007). The raters observed an improvement in post-treatment voice in 73.4% of cases, and CAPE-V scores showed a reduction of 18.8 points on average (p = 0.036). The videostroboscopic VALI ratings showed an improvement in mucosal wave rating from 2.0 to 4.0. On average, the raters perceived the post-PRP exams to be better in 56.7% of cases.

Conclusions: PRP has been validated as a safe autologous option for treatment of vocal fold scar. While results for mucosal wave and voice quality varied, there was a consistent improvement in PROMs.

Level of evidence: 3: Prospective cohort study, with blinded analysis Laryngoscope, 134:5021-5027, 2024.

Keywords: platelet‐rich plasma; sulcus vocalis; superficial lamina propria deficiency; vocal fold scar; vocal fold sulcus.

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References

    1. Hsiung MW, Woo P, Wang HW, Su WY. A clinical classification and histopathological study of sulcus vocalis. Eur Arch Otorhinolaryngol. 2000;257(8):466–8. - PubMed
    1. Hamilton NJI. The life-cycle and restoration of the human vocal fold. Laryngoscope Investig Otolaryngol. 2022;8(1):168–176 - PMC - PubMed
    1. Gray SD, Titze IR, Chan R, Hammond TH. Vocal fold proteoglycans and their influence on biomechanics. Laryngoscope. 1999;109(6):845–54. - PubMed
    1. Benninger MS, Alessi D, Archer S, Bastian R, Ford C, Koufman J, Sataloff RT, Spiegel JR, Woo P. Vocal fold scarring: current concepts and management. Otolaryngol Head Neck Surg. 1996;115(5):474–82. - PubMed
    1. Welham NV, Choi SH, Dailey SH, Ford CN, Jiang JJ, Bless DM. Prospective multi-arm evaluation of surgical treatments for vocal fold scar and pathologic sulcus vocalis. Laryngoscope. 2011;121(6):1252–60. - PMC - PubMed

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