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Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis--preliminary results.
J Voice. 2012 Jul; 26(4):506-14.JV

Abstract

OBJECTIVES

The purpose of this study is to investigate the feasibility of using an injectable needle electrode to guide hyaluronic acid (HA) vocal fold injection (VFI) during laryngeal electromyography (LEMG) for unilateral vocal fold paralysis (UVFP).

STUDY DESIGN

Prospective study.

METHODS

From March to June 2010, 20 UVFP patients received LEMG examination at our clinic. Before completion of LEMG, 1.0 cc of HA (Restylane Perlane(®); Q-Med, Uppsala, Sweden) was injected via a 26-gauge monopolar injectable needle electrode into paralyzed thyroarytenoid muscle. After injection, 20 patients completed 3-months follow-up and 16 patients completed 6-months follow-up. The data before, 1 week, 3 months, and 6 months after injection, including the normalized glottal gap area (NGGA) from videostroboscopy, maximal phonation time (MPT), mean airflow rate (MAFR), phonation quotient (PQ), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain [GRBAS] scale), Voice Handicap Index (VHI), and self-grading of choking (grade 1-7), were analyzed by the Wilcoxon signed rank test.

RESULTS

All of the patients completed the procedure without complications. After injection, mean NGGA was significantly reduced from 8.28 units to 0.52 units (1 week), 1.79 units (3 months), and 1.36 units (6 months). The mean MPT was prolonged from 5.66 seconds to 11.73, 11.25, and 11.93 seconds, respectively. VHI was reduced from 76.05 to 38.10, 37.40 and 35.00, respectively. Other analyzed data (PQ, MAFR, GRBAS scale, and choking severity) also showed statistically significant improvement.

CONCLUSION

LEMG-guided HA VFI provides UVFP patients with neuromuscular function evaluation and treatment in one step. This clinical technique is feasible, and the short-term results are satisfactory.

Authors+Show Affiliations

Department of Medicine, National Yang-Ming University, Taipei, Taiwan. entccwang@msn.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21816569

Citation

Wang, Chen-Chi, et al. "Laryngeal Electromyography-guided Hyaluronic Acid Vocal Fold Injection for Unilateral Vocal Fold Paralysis--preliminary Results." Journal of Voice : Official Journal of the Voice Foundation, vol. 26, no. 4, 2012, pp. 506-14.
Wang CC, Chang MH, Wang CP, et al. Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis--preliminary results. J Voice. 2012;26(4):506-14.
Wang, C. C., Chang, M. H., Wang, C. P., Liu, S. A., Liang, K. L., Wu, S. H., Jiang, R. S., Huang, H. T., & Lai, H. C. (2012). Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis--preliminary results. Journal of Voice : Official Journal of the Voice Foundation, 26(4), 506-14. https://doi.org/10.1016/j.jvoice.2011.04.003
Wang CC, et al. Laryngeal Electromyography-guided Hyaluronic Acid Vocal Fold Injection for Unilateral Vocal Fold Paralysis--preliminary Results. J Voice. 2012;26(4):506-14. PubMed PMID: 21816569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis--preliminary results. AU - Wang,Chen-Chi, AU - Chang,Ming-Hong, AU - Wang,Ching-Ping, AU - Liu,Shi-An, AU - Liang,Kai-Li, AU - Wu,Shang-Heng, AU - Jiang,Rong-San, AU - Huang,Hui-Tsu, AU - Lai,Hsiu-Chin, Y1 - 2011/08/04/ PY - 2010/11/06/received PY - 2011/04/11/accepted PY - 2011/8/6/entrez PY - 2011/8/6/pubmed PY - 2012/12/10/medline SP - 506 EP - 14 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 26 IS - 4 N2 - OBJECTIVES: The purpose of this study is to investigate the feasibility of using an injectable needle electrode to guide hyaluronic acid (HA) vocal fold injection (VFI) during laryngeal electromyography (LEMG) for unilateral vocal fold paralysis (UVFP). STUDY DESIGN: Prospective study. METHODS: From March to June 2010, 20 UVFP patients received LEMG examination at our clinic. Before completion of LEMG, 1.0 cc of HA (Restylane Perlane(®); Q-Med, Uppsala, Sweden) was injected via a 26-gauge monopolar injectable needle electrode into paralyzed thyroarytenoid muscle. After injection, 20 patients completed 3-months follow-up and 16 patients completed 6-months follow-up. The data before, 1 week, 3 months, and 6 months after injection, including the normalized glottal gap area (NGGA) from videostroboscopy, maximal phonation time (MPT), mean airflow rate (MAFR), phonation quotient (PQ), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain [GRBAS] scale), Voice Handicap Index (VHI), and self-grading of choking (grade 1-7), were analyzed by the Wilcoxon signed rank test. RESULTS: All of the patients completed the procedure without complications. After injection, mean NGGA was significantly reduced from 8.28 units to 0.52 units (1 week), 1.79 units (3 months), and 1.36 units (6 months). The mean MPT was prolonged from 5.66 seconds to 11.73, 11.25, and 11.93 seconds, respectively. VHI was reduced from 76.05 to 38.10, 37.40 and 35.00, respectively. Other analyzed data (PQ, MAFR, GRBAS scale, and choking severity) also showed statistically significant improvement. CONCLUSION: LEMG-guided HA VFI provides UVFP patients with neuromuscular function evaluation and treatment in one step. This clinical technique is feasible, and the short-term results are satisfactory. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/21816569/Laryngeal_electromyography_guided_hyaluronic_acid_vocal_fold_injection_for_unilateral_vocal_fold_paralysis__preliminary_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(11)00066-X DB - PRIME DP - Unbound Medicine ER -