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Posterior glottic gap and age as factors predicting voice outcome of injection laryngoplasty in patients with unilateral vocal fold paralysis

Published online by Cambridge University Press:  06 October 2011

J Choi ,
Y-I Son ,
Y K So ,
H Byun ,
E-K Lee  and
Y-S Yun
J Choi
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
Y-I Son*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
Y K So
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Inje University Haeundae Paik Hospital, Busan, South Korea
H Byun
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
E-K Lee
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
Y-S Yun
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
*
Address for correspondence: Dr Young-Ik Son, Department of Otorhinolaryngology – Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Ilwon-dong, Gangnam-gu, 135-710 Seoul, South Korea Fax: +82 2 3410 3879 E-mail: yison@skku.edu
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Abstract

Objectives:

This study aimed to analyse demographic profiles and pre-injection stroboscopic findings for patients with unilateral vocal fold paralysis, to investigate possible predictive factors for voice outcomes of injection laryngoplasty.

Materials and methods:

Fifty-nine unilateral vocal fold paralysis patients underwent vocal fold augmentation, using transcutaneous Artecoll (polymethyl methacrylate microspheres plus bovine collagen) injection into the paralysed vocal fold via the cricothyroid space. Three months later, patients were divided into improved (n = 44) and unimproved (n = 15) groups, using the perceptual grade-roughness-breathiness-asthenia-strain scale, and their clinical characteristics and pre-operative stroboscopic findings compared.

Results:

The improved group were significantly younger than the unimproved group (p = 0.000). The size of the posterior gap on phonation was closely associated with the outcome of injection laryngoplasty (p = 0.015).

Conclusion:

Younger patients with a smaller posterior glottic gap on phonation can be expected to have a more favourable outcome following injection laryngoplasty for correction of glottic insufficiency due to unilateral vocal fold paralysis.

Keywords

Vocal Cord ParalysisInjectionsStroboscopyAgedArtecoll
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 3 , March 2012 , pp. 260 - 266
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Morgan, JE, Zraick, RI, Griffin, AW, Bowen, TL, Johnson, FL. Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis. Laryngoscope 2007;117:2068–74CrossRefGoogle ScholarPubMed
2Kwon, TK, Buckmire, R. Injection laryngoplasty for management of unilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg 2004;12:538–42CrossRefGoogle ScholarPubMed
3King, JM, Simpson, CB. Modern injection augmentation for glottic insufficiency. Curr Opin Otolaryngol Head Neck Surg 2007;15:153–8CrossRefGoogle ScholarPubMed
4Rosen, CA, Thekdi, AA. Vocal fold augmentation with injectable calcium hydroxylapatite: short-term results. J Voice 2004;18:387–91CrossRefGoogle ScholarPubMed
5Sittel, C, Echternach, M, Federspil, PA, Plinkert, PK. Polydimethylsiloxane particles for permanent injection laryngoplasty. Ann Otol Rhinol Laryngol 2006;115:103–9CrossRefGoogle ScholarPubMed
6Cohen, SR, Holmes, RE. Artecoll: a long-lasting injectable wrinkle filler material: report of a controlled, randomized, multicenter clinical trial of 251 subjects. Plast Reconstr Surg 2004;114:964–76, 77–9CrossRefGoogle ScholarPubMed
7Lemperle, G, Romano, JJ, Busso, M. Soft tissue augmentation with artecoll: 10-year history, indications, techniques, and complications. Dermatol Surg 2003;29:573–87Google ScholarPubMed
8Bagal, A, Dahiya, R, Tsai, V, Adamson, PA. Clinical experience with polymethylmethacrylate microspheres (Artecoll) for soft-tissue augmentation: a retrospective review. Arch Facial Plast Surg 2007;9:275–80CrossRefGoogle ScholarPubMed
9Lemperle, G, Knapp, TR, Sadick, NS, Lemperle, SM. ArteFill((R)) permanent injectable for soft tissue augmentation: I. Mechanism of action and injection techniques. Aesthetic Plast Surg 2010;34:264–72CrossRefGoogle Scholar
10Min, JY, Hong, SD, Kim, K, Son, YI. Long-term results of Artecoll injection laryngoplasty for patients with unilateral vocal fold motion impairment: safety and clinical efficacy. Arch Otolaryngol Head Neck Surg 2008;134:490–6CrossRefGoogle ScholarPubMed
11Oken, MM, Creech, RH, Tormey, DC, Horton, J, Davis, TE, McFadden, ET et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649–55CrossRefGoogle ScholarPubMed
12Webb, AL, Carding, PN, Deary, IJ, MacKenzie, K, Steen, N, Wilson, JA. The reliability of three perceptual evaluation scales for dysphonia. Eur Arch Otorhinolaryngol 2004;261:429–34CrossRefGoogle ScholarPubMed
13Rihkanen, H, Reijonen, P, Lehikoinen-Soderlund, S, Lauri, ER. Videostroboscopic assessment of unilateral vocal fold paralysis after augmentation with autologous fascia. Eur Arch Otorhinolaryngol 2004;261:177–83Google ScholarPubMed
14Hong, KH, Jung, KS. Arytenoid appearance and vertical level difference between the paralyzed and innervated vocal cords. Laryngoscope 2001;111:227–32CrossRefGoogle ScholarPubMed
15Hirano, S, Kishimoto, Y, Suehiro, A, Kanemaru, S, Ito, J. Regeneration of aged vocal fold: first human case treated with fibroblast growth factor. Laryngoscope 2009;119:197–202CrossRefGoogle ScholarPubMed
16Rubin, HJ. Pitfalls in treatment of dysphonias by intracordal injection of synthetics. Laryngoscope 1965;75:1381–97CrossRefGoogle ScholarPubMed
17Hirano, M, Kurita, S, Sakaguchi, S. Ageing of the vibratory tissue of human vocal folds. Acta Otolaryngol 1989;107:428–33CrossRefGoogle ScholarPubMed
18Sato, K, Hirano, M, Nakashima, T. Age-related changes of collagenous fibers in the human vocal fold mucosa. Ann Otol Rhinol Laryngol 2002;111:15–20CrossRefGoogle ScholarPubMed
19Sato, K, Hirano, M. Age-related changes of elastic fibers in the superficial layer of the lamina propria of vocal folds. Ann Otol Rhinol Laryngol 1997;106:44–8CrossRefGoogle ScholarPubMed
20Ashcroft, GS, Mills, SJ, Ashworth, JJ. Ageing and wound healing. Biogerontology 2002;3:337–45CrossRefGoogle ScholarPubMed