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Injection laryngoplasty outcomes in irradiated and nonirradiated unilateral vocal fold paralysis.
Laryngoscope. 2014 Aug; 124(8):1895-9.L

Abstract

OBJECTIVES/HYPOTHESIS

To evaluate the effect of radiation therapy on voice outcome and duration of effect of calcium hydroxylapatite (CaHA) injection laryngoplasty in unilateral vocal fold paralysis (UVFP) patients.

STUDY DESIGN

Retrospective case series.

METHODS

UVFP patients treated with CaHA injection laryngoplasty at the University of California San Francisco Voice and Swallowing Center were identified. Demographic information, history of irradiation to the larynx, and time to additional medialization procedures were obtained. Examinations at presentation and follow-up were analyzed for laryngostroboscopic parameters and CAPE-V scores.

RESULTS

Four nonirradiated and five irradiated patients underwent a total of six and nine injection laryngoplasties, respectively. Time to additional procedures was longer in irradiated patients (P = 0.02). Prior to injection, nonirradiated patients had more severe glottic insufficiency (P = 0.007, 0.002) than did irradiated patients. Postinjection, irradiated patients demonstrated improvement in overall voice quality, breathiness, and loudness, while nonirradiated patients demonstrated improved overall quality, breathiness, pitch, and loudness. Voice quality was not statistically different between patient groups.

CONCLUSION

CaHA injection laryngoplasty improved voice quality in both irradiated and nonirradiated patients. Nonirradiated patients experience greater vocal improvement compared to irradiated patients. Vocal cord stiffness due to radiation-induced changes may be responsible for the lack of improvement in pitch. Time to additional procedures was longer in irradiated patients and may be secondary to effects of prior radiation on graft resorption. Vocal fold medialization with CaHA injection remains a safe and efficacious treatment for UVFP in both irradiated and nonirradiated patients.

Authors+Show Affiliations

School of Medicine, University of California, San Francisco, San Francisco, California, U.S.A.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24473831

Citation

Chang, Joseph, et al. "Injection Laryngoplasty Outcomes in Irradiated and Nonirradiated Unilateral Vocal Fold Paralysis." The Laryngoscope, vol. 124, no. 8, 2014, pp. 1895-9.
Chang J, Courey MS, Al-Jurf SA, et al. Injection laryngoplasty outcomes in irradiated and nonirradiated unilateral vocal fold paralysis. Laryngoscope. 2014;124(8):1895-9.
Chang, J., Courey, M. S., Al-Jurf, S. A., Schneider, S. L., & Yung, K. C. (2014). Injection laryngoplasty outcomes in irradiated and nonirradiated unilateral vocal fold paralysis. The Laryngoscope, 124(8), 1895-9. https://doi.org/10.1002/lary.24622
Chang J, et al. Injection Laryngoplasty Outcomes in Irradiated and Nonirradiated Unilateral Vocal Fold Paralysis. Laryngoscope. 2014;124(8):1895-9. PubMed PMID: 24473831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Injection laryngoplasty outcomes in irradiated and nonirradiated unilateral vocal fold paralysis. AU - Chang,Joseph, AU - Courey,Mark S, AU - Al-Jurf,Soha A, AU - Schneider,Sarah L, AU - Yung,Katherine C, Y1 - 2014/03/19/ PY - 2014/01/24/accepted PY - 2014/1/30/entrez PY - 2014/1/30/pubmed PY - 2014/9/23/medline KW - Laryngoplasty KW - calcium hydroxylapatite KW - glottic insufficiency KW - radiation KW - unilateral vocal fold paralysis KW - vocal fold injection KW - voice SP - 1895 EP - 9 JF - The Laryngoscope JO - Laryngoscope VL - 124 IS - 8 N2 - OBJECTIVES/HYPOTHESIS: To evaluate the effect of radiation therapy on voice outcome and duration of effect of calcium hydroxylapatite (CaHA) injection laryngoplasty in unilateral vocal fold paralysis (UVFP) patients. STUDY DESIGN: Retrospective case series. METHODS: UVFP patients treated with CaHA injection laryngoplasty at the University of California San Francisco Voice and Swallowing Center were identified. Demographic information, history of irradiation to the larynx, and time to additional medialization procedures were obtained. Examinations at presentation and follow-up were analyzed for laryngostroboscopic parameters and CAPE-V scores. RESULTS: Four nonirradiated and five irradiated patients underwent a total of six and nine injection laryngoplasties, respectively. Time to additional procedures was longer in irradiated patients (P = 0.02). Prior to injection, nonirradiated patients had more severe glottic insufficiency (P = 0.007, 0.002) than did irradiated patients. Postinjection, irradiated patients demonstrated improvement in overall voice quality, breathiness, and loudness, while nonirradiated patients demonstrated improved overall quality, breathiness, pitch, and loudness. Voice quality was not statistically different between patient groups. CONCLUSION: CaHA injection laryngoplasty improved voice quality in both irradiated and nonirradiated patients. Nonirradiated patients experience greater vocal improvement compared to irradiated patients. Vocal cord stiffness due to radiation-induced changes may be responsible for the lack of improvement in pitch. Time to additional procedures was longer in irradiated patients and may be secondary to effects of prior radiation on graft resorption. Vocal fold medialization with CaHA injection remains a safe and efficacious treatment for UVFP in both irradiated and nonirradiated patients. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/24473831/Injection_laryngoplasty_outcomes_in_irradiated_and_nonirradiated_unilateral_vocal_fold_paralysis_ L2 - https://doi.org/10.1002/lary.24622 DB - PRIME DP - Unbound Medicine ER -