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Comparative analysis on the efficiency of the injection laryngoplasty technique using calcium hydroxyapatite (CaHA): the thyrohyoid approach versus the cricothyroid approach.
J Voice. 2013 Mar; 27(2):236-41.JV

Abstract

OBJECTIVES

Temporary or permanent vocal paralysis can occur after head and neck surgery for thyroid cancer, esophageal resection, a chest operation that includes lung parenchymal resection due to a vagus or recurrent laryngeal nerve injury, and so forth. These days, the main treatment for vocal fold paralysis is the injection laryngoplasty through the cricothyroid (CT) approach. However, the CT approach is difficult in that an operator cannot see from the tip of the needle to the vocal fold. The aim of this study was to determine the efficacy of the thyrohyoid (TH) approach compared with the CT approach using calcium hydroxyapatite (CaHA) in patients with permanent unilateral vocal fold palsy.

METHODS

From March 2008 to July 2012, 68 consecutive injection laryngoplasties were performed in patients with unilateral glottic insufficiency. Percutaneous injection was performed under local anesthesia into the vocalis muscle, using disposable 25 gauge, 11cm long spinal needles through the CT membrane or TH membrane. Of the 68 patients, videostroboscopic findings and acoustic, perceptual, and subjective evaluations were completed for 64 patients before injection and at 3 months after injection.

RESULTS

In the 64 patients, the CT and TH approaches were used in 30 and 34 patients, respectively. The videostroboscopic findings, acoustic and perceptual parameters (maximum phonation time, jitter, shimmer, and noise-to-harmonic ratio), and Voice Handicap Index significantly improved after the injection in both the CT and TH groups (P<0.05).

CONCLUSION

Based on the results of this trial, injection laryngoplasty using the TH approach is an effective alternative to the CT approach, especially for the injection of CaHA in patients with permanent unilateral vocal fold palsy.

Authors+Show Affiliations

Department of Otolaryngology, Institute of Health Sciences, Gyeongsang National University, Jinju, Korea. lesaby@hanmail.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23280385

Citation

Woo, Seung Hoon, et al. "Comparative Analysis On the Efficiency of the Injection Laryngoplasty Technique Using Calcium Hydroxyapatite (CaHA): the Thyrohyoid Approach Versus the Cricothyroid Approach." Journal of Voice : Official Journal of the Voice Foundation, vol. 27, no. 2, 2013, pp. 236-41.
Woo SH, Son YI, Lee SH, et al. Comparative analysis on the efficiency of the injection laryngoplasty technique using calcium hydroxyapatite (CaHA): the thyrohyoid approach versus the cricothyroid approach. J Voice. 2013;27(2):236-41.
Woo, S. H., Son, Y. I., Lee, S. H., Park, J. J., & Kim, J. P. (2013). Comparative analysis on the efficiency of the injection laryngoplasty technique using calcium hydroxyapatite (CaHA): the thyrohyoid approach versus the cricothyroid approach. Journal of Voice : Official Journal of the Voice Foundation, 27(2), 236-41. https://doi.org/10.1016/j.jvoice.2012.11.001
Woo SH, et al. Comparative Analysis On the Efficiency of the Injection Laryngoplasty Technique Using Calcium Hydroxyapatite (CaHA): the Thyrohyoid Approach Versus the Cricothyroid Approach. J Voice. 2013;27(2):236-41. PubMed PMID: 23280385.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative analysis on the efficiency of the injection laryngoplasty technique using calcium hydroxyapatite (CaHA): the thyrohyoid approach versus the cricothyroid approach. AU - Woo,Seung Hoon, AU - Son,Young-Ik, AU - Lee,Sang Hyuk, AU - Park,Jung Je, AU - Kim,Jin Pyeong, Y1 - 2012/12/29/ PY - 2012/08/24/received PY - 2012/10/31/revised PY - 2012/10/18/accepted PY - 2013/1/3/entrez PY - 2013/1/3/pubmed PY - 2013/9/26/medline SP - 236 EP - 41 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 27 IS - 2 N2 - OBJECTIVES: Temporary or permanent vocal paralysis can occur after head and neck surgery for thyroid cancer, esophageal resection, a chest operation that includes lung parenchymal resection due to a vagus or recurrent laryngeal nerve injury, and so forth. These days, the main treatment for vocal fold paralysis is the injection laryngoplasty through the cricothyroid (CT) approach. However, the CT approach is difficult in that an operator cannot see from the tip of the needle to the vocal fold. The aim of this study was to determine the efficacy of the thyrohyoid (TH) approach compared with the CT approach using calcium hydroxyapatite (CaHA) in patients with permanent unilateral vocal fold palsy. METHODS: From March 2008 to July 2012, 68 consecutive injection laryngoplasties were performed in patients with unilateral glottic insufficiency. Percutaneous injection was performed under local anesthesia into the vocalis muscle, using disposable 25 gauge, 11cm long spinal needles through the CT membrane or TH membrane. Of the 68 patients, videostroboscopic findings and acoustic, perceptual, and subjective evaluations were completed for 64 patients before injection and at 3 months after injection. RESULTS: In the 64 patients, the CT and TH approaches were used in 30 and 34 patients, respectively. The videostroboscopic findings, acoustic and perceptual parameters (maximum phonation time, jitter, shimmer, and noise-to-harmonic ratio), and Voice Handicap Index significantly improved after the injection in both the CT and TH groups (P<0.05). CONCLUSION: Based on the results of this trial, injection laryngoplasty using the TH approach is an effective alternative to the CT approach, especially for the injection of CaHA in patients with permanent unilateral vocal fold palsy. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/23280385/Comparative_analysis_on_the_efficiency_of_the_injection_laryngoplasty_technique_using_calcium_hydroxyapatite__CaHA_:_the_thyrohyoid_approach_versus_the_cricothyroid_approach_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(12)00191-9 DB - PRIME DP - Unbound Medicine ER -