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Implantation of esterified hyaluronic acid in microdissected Reinke's space after vocal fold microsurgery: short- and long-term results.
J Voice. 2010 Sep; 24(5):626-35.JV

Abstract

In this study are reported the laryngeal and vocal results obtained after a microflap excision of benign vocal fold (VF) lesions and immediate implantation of esterified hyaluronic acid (EHA) in the surgical wound. In a previous pilot study on 11 cases, we have shown an excellent tolerance of this bioimplant. The objectives are to confirm the innocuity of the technique, to demonstrate the laryngeal and vocal evolution at short and long term, and to evaluate the eventual positive impact of EHA implantation on the pliability of the superficial layer of the lamina propria (SLLP) and on voice. This is a prospective and comparative study on 83 patients suffering from various benign VF lesions. Thirty-three patients were implanted with EHA, whereas 50 patients did not undergo implantation at the end of the microsurgical procedure. All patients undergo rigid laryngoscopy and microflap excision procedure under general anesthesia. After freeing up of the Reinke's space and creation of a mucosal microflap, a few fibers of EHA are inserted in the surgical wound, before closure of the incision with fibrin glue. Serial laryngeal and vocal assessments are performed in all patients using videostroboscopy (Wolff and Xion), perceptual and objective voice evaluation (MDVP software, Kay Elemetrics), and phonatory function measurements (Aerophone II). Pre- and early postoperative means are compared by analysis of variance. Delayed and long-term evolution of laryngeal and vocal data are compared by means of nonparametric statistical methods. The longest follow-up in the implanted group is 4 years. Early postoperative results are similar in both groups: a significant improvement of a majority of laryngeal and vocal data is observed after microsurgery. In the long term, the two groups exhibit a different behavior: further improvement of voice, as an ongoing process, is only observed in the EHA implanted group, together with improvement of some videostroboscopic characteristics. The nonimplanted group remains stable, with no further improvement of the voice quality obtained after microsurgery. Excellent short- and long-term tolerance of EHA implantation is confirmed by this larger series. The use of EHA implant in microdissected SLLP is safe and leads to good laryngeal and vocal outcomes in the treated patients. More interestingly, treated cases exhibit a continuous improvement over a long period of time.

Authors+Show Affiliations

Department of Otorhinolaryngology, University of Liège, Liège, Belgium. Camille.finck@chu.ulg.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19853408

Citation

Finck, Camille L., et al. "Implantation of Esterified Hyaluronic Acid in Microdissected Reinke's Space After Vocal Fold Microsurgery: Short- and Long-term Results." Journal of Voice : Official Journal of the Voice Foundation, vol. 24, no. 5, 2010, pp. 626-35.
Finck CL, Harmegnies B, Remacle A, et al. Implantation of esterified hyaluronic acid in microdissected Reinke's space after vocal fold microsurgery: short- and long-term results. J Voice. 2010;24(5):626-35.
Finck, C. L., Harmegnies, B., Remacle, A., & Lefebvre, P. (2010). Implantation of esterified hyaluronic acid in microdissected Reinke's space after vocal fold microsurgery: short- and long-term results. Journal of Voice : Official Journal of the Voice Foundation, 24(5), 626-35. https://doi.org/10.1016/j.jvoice.2008.12.015
Finck CL, et al. Implantation of Esterified Hyaluronic Acid in Microdissected Reinke's Space After Vocal Fold Microsurgery: Short- and Long-term Results. J Voice. 2010;24(5):626-35. PubMed PMID: 19853408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implantation of esterified hyaluronic acid in microdissected Reinke's space after vocal fold microsurgery: short- and long-term results. AU - Finck,Camille L, AU - Harmegnies,Bernard, AU - Remacle,Angélique, AU - Lefebvre,Philippe, Y1 - 2009/10/22/ PY - 2008/10/09/received PY - 2008/12/31/accepted PY - 2009/10/27/entrez PY - 2009/10/27/pubmed PY - 2010/12/21/medline SP - 626 EP - 35 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 24 IS - 5 N2 - In this study are reported the laryngeal and vocal results obtained after a microflap excision of benign vocal fold (VF) lesions and immediate implantation of esterified hyaluronic acid (EHA) in the surgical wound. In a previous pilot study on 11 cases, we have shown an excellent tolerance of this bioimplant. The objectives are to confirm the innocuity of the technique, to demonstrate the laryngeal and vocal evolution at short and long term, and to evaluate the eventual positive impact of EHA implantation on the pliability of the superficial layer of the lamina propria (SLLP) and on voice. This is a prospective and comparative study on 83 patients suffering from various benign VF lesions. Thirty-three patients were implanted with EHA, whereas 50 patients did not undergo implantation at the end of the microsurgical procedure. All patients undergo rigid laryngoscopy and microflap excision procedure under general anesthesia. After freeing up of the Reinke's space and creation of a mucosal microflap, a few fibers of EHA are inserted in the surgical wound, before closure of the incision with fibrin glue. Serial laryngeal and vocal assessments are performed in all patients using videostroboscopy (Wolff and Xion), perceptual and objective voice evaluation (MDVP software, Kay Elemetrics), and phonatory function measurements (Aerophone II). Pre- and early postoperative means are compared by analysis of variance. Delayed and long-term evolution of laryngeal and vocal data are compared by means of nonparametric statistical methods. The longest follow-up in the implanted group is 4 years. Early postoperative results are similar in both groups: a significant improvement of a majority of laryngeal and vocal data is observed after microsurgery. In the long term, the two groups exhibit a different behavior: further improvement of voice, as an ongoing process, is only observed in the EHA implanted group, together with improvement of some videostroboscopic characteristics. The nonimplanted group remains stable, with no further improvement of the voice quality obtained after microsurgery. Excellent short- and long-term tolerance of EHA implantation is confirmed by this larger series. The use of EHA implant in microdissected SLLP is safe and leads to good laryngeal and vocal outcomes in the treated patients. More interestingly, treated cases exhibit a continuous improvement over a long period of time. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/19853408/Implantation_of_esterified_hyaluronic_acid_in_microdissected_Reinke's_space_after_vocal_fold_microsurgery:_short__and_long_term_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(09)00004-6 DB - PRIME DP - Unbound Medicine ER -