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Laryngoplasty with hyaluronic acid in patients with unilateral vocal fold paralysis.
J Voice. 2012 Nov; 26(6):785-91.JV

Abstract

OBJECTIVES

Augmentation of vocal fold with hyaluronic acid (Restylane; Q-Med AB, Uppsala, Sweden) is used as a therapeutic option for insufficient glottic closure in unilateral vocal fold paralysis (UVP). Analysis of the optimal glottic width, effectiveness (long-term voice improvement as a consequence of longevity of Restylane), and safety of this new method was made.

STUDY DESIGN/METHODS

In a prospective clinical cohort study, 19 consecutive patients with UVP who received vocal fold augmentation with hyaluronic acid (Restylane) were examined preoperatively; 6 weeks, 6, and 12 months postoperatively by laryngostroboscopy; and their voice was evaluated by subjective, objective, and self-assessment (Voice Handicap Index).

RESULTS

In 11 of 19 (58%) patients, a subjectively and objectively acceptable voice quality was observed in a follow-up of 12 months. Eight of 19 (42%) patients had a considerable impairment of the voice after 6 weeks (range: 1-24 weeks). Therefore, another intervention (eg, injection laryngoplasty or thyroplasty) was recommended. An impairment of voice was mainly observed if the preoperative glottal gap during phonation was more than 1 mm.

CONCLUSION

A long duration (up to 12 months) of acceptable quality of voice was achieved by augmentation with Restylane, if the glottal gap was 1 mm or less videolaryngostroboscopically during phonation. The authors recommend this therapy for temporary voice improvement and to augment vocal therapy, if spontaneous recovery of voice is likely. Long-term results remain to be seen.

Authors+Show Affiliations

Department of Otolaryngology Head and Neck Surgery, Section of Phoniatrics and Pedaudiology, University of Ulm, Ulm, Germany. rudolf.reiter@uniklinik-ulm.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22578435

Citation

Reiter, Rudolf, et al. "Laryngoplasty With Hyaluronic Acid in Patients With Unilateral Vocal Fold Paralysis." Journal of Voice : Official Journal of the Voice Foundation, vol. 26, no. 6, 2012, pp. 785-91.
Reiter R, Rudolf R, Brosch S, et al. Laryngoplasty with hyaluronic acid in patients with unilateral vocal fold paralysis. J Voice. 2012;26(6):785-91.
Reiter, R., Rudolf, R., Brosch, S., & Sibylle, B. (2012). Laryngoplasty with hyaluronic acid in patients with unilateral vocal fold paralysis. Journal of Voice : Official Journal of the Voice Foundation, 26(6), 785-91. https://doi.org/10.1016/j.jvoice.2011.11.007
Reiter R, et al. Laryngoplasty With Hyaluronic Acid in Patients With Unilateral Vocal Fold Paralysis. J Voice. 2012;26(6):785-91. PubMed PMID: 22578435.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laryngoplasty with hyaluronic acid in patients with unilateral vocal fold paralysis. AU - Reiter,Rudolf, AU - Rudolf,Reiter, AU - Brosch,Sibylle, AU - Sibylle,Brosch, Y1 - 2012/05/11/ PY - 2011/09/22/received PY - 2011/11/11/accepted PY - 2012/5/15/entrez PY - 2012/5/15/pubmed PY - 2013/5/15/medline SP - 785 EP - 91 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 26 IS - 6 N2 - OBJECTIVES: Augmentation of vocal fold with hyaluronic acid (Restylane; Q-Med AB, Uppsala, Sweden) is used as a therapeutic option for insufficient glottic closure in unilateral vocal fold paralysis (UVP). Analysis of the optimal glottic width, effectiveness (long-term voice improvement as a consequence of longevity of Restylane), and safety of this new method was made. STUDY DESIGN/METHODS: In a prospective clinical cohort study, 19 consecutive patients with UVP who received vocal fold augmentation with hyaluronic acid (Restylane) were examined preoperatively; 6 weeks, 6, and 12 months postoperatively by laryngostroboscopy; and their voice was evaluated by subjective, objective, and self-assessment (Voice Handicap Index). RESULTS: In 11 of 19 (58%) patients, a subjectively and objectively acceptable voice quality was observed in a follow-up of 12 months. Eight of 19 (42%) patients had a considerable impairment of the voice after 6 weeks (range: 1-24 weeks). Therefore, another intervention (eg, injection laryngoplasty or thyroplasty) was recommended. An impairment of voice was mainly observed if the preoperative glottal gap during phonation was more than 1 mm. CONCLUSION: A long duration (up to 12 months) of acceptable quality of voice was achieved by augmentation with Restylane, if the glottal gap was 1 mm or less videolaryngostroboscopically during phonation. The authors recommend this therapy for temporary voice improvement and to augment vocal therapy, if spontaneous recovery of voice is likely. Long-term results remain to be seen. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/22578435/Laryngoplasty_with_hyaluronic_acid_in_patients_with_unilateral_vocal_fold_paralysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(11)00209-8 DB - PRIME DP - Unbound Medicine ER -