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Injection Laryngoplasty Using Micronized Acellular Dermis for Vocal Fold Paralysis: Long-term Voice Outcomes.
Otolaryngol Head Neck Surg. 2016 05; 154(5):892-7.OH

Abstract

OBJECTIVES

Micronized acellular dermis has been used for nearly 15 years to correct glottic insufficiency. With previous demonstration of safety and efficacy, this study aims to evaluate intermediate and long-term voice outcomes in those who underwent injection laryngoplasty for unilateral vocal fold paralysis. Technique and timing of injection were also reviewed to assess their impact on outcomes.

STUDY DESIGN

Case series with chart review.

SETTING

Tertiary care center.

SUBJECTS AND METHODS

Patients undergoing injection laryngoplasty from May 2007 to September 2012 were reviewed for possible inclusion. Pre- and postoperative Voice Handicap Index (VHI) scores, as well as senior speech-language pathologists' blinded assessment of voice, were collected for analysis. The final sample included patients who underwent injection laryngoplasty for unilateral vocal fold paralysis, 33 of whom had VHI results and 37 of whom had voice recordings. Additional data were obtained, including technique and timing of injection.

RESULTS

Analysis was performed on those patients above with VHI and perceptual voice grades before and at least 6 months following injection. Mean VHI improved by 28.7 points at 6 to 12 months and 22.8 points at >12 months (P = .001). Mean perceptual voice grades improved by 17.6 points at 6 to 12 months and 16.3 points at >12 months (P < .001). No statistically significant difference was found with technique or time to injection.

CONCLUSION

Micronized acellular dermis is a safe injectable that improved both patient-completed voice ratings and blinded reviewer voice gradings at intermediate and long-term follow-up. Further investigation may be warranted regarding technique and timing of injection.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA sherna@lsuhsc.edu.Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA Voice Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA.Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA Voice Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana, USA.Voice Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA.Merial Limited, North Brunswick, New Jersey, USA.Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA Voice Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26932966

Citation

Hernandez, Stephen C., et al. "Injection Laryngoplasty Using Micronized Acellular Dermis for Vocal Fold Paralysis: Long-term Voice Outcomes." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 154, no. 5, 2016, pp. 892-7.
Hernandez SC, Sibley H, Fink DS, et al. Injection Laryngoplasty Using Micronized Acellular Dermis for Vocal Fold Paralysis: Long-term Voice Outcomes. Otolaryngol Head Neck Surg. 2016;154(5):892-7.
Hernandez, S. C., Sibley, H., Fink, D. S., Kunduk, M., Schexnaildre, M., Kakade, A., & McWhorter, A. J. (2016). Injection Laryngoplasty Using Micronized Acellular Dermis for Vocal Fold Paralysis: Long-term Voice Outcomes. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 154(5), 892-7. https://doi.org/10.1177/0194599816630971
Hernandez SC, et al. Injection Laryngoplasty Using Micronized Acellular Dermis for Vocal Fold Paralysis: Long-term Voice Outcomes. Otolaryngol Head Neck Surg. 2016;154(5):892-7. PubMed PMID: 26932966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Injection Laryngoplasty Using Micronized Acellular Dermis for Vocal Fold Paralysis: Long-term Voice Outcomes. AU - Hernandez,Stephen C, AU - Sibley,Haley, AU - Fink,Daniel S, AU - Kunduk,Melda, AU - Schexnaildre,Mell, AU - Kakade,Anagha, AU - McWhorter,Andrew J, Y1 - 2016/03/01/ PY - 2015/08/21/received PY - 2016/01/15/accepted PY - 2016/3/3/entrez PY - 2016/3/5/pubmed PY - 2017/7/18/medline KW - glottal incompetence KW - injection laryngoplasty KW - micronized acellular dermis KW - vocal cord injection KW - vocal fold paralysis SP - 892 EP - 7 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 154 IS - 5 N2 - OBJECTIVES: Micronized acellular dermis has been used for nearly 15 years to correct glottic insufficiency. With previous demonstration of safety and efficacy, this study aims to evaluate intermediate and long-term voice outcomes in those who underwent injection laryngoplasty for unilateral vocal fold paralysis. Technique and timing of injection were also reviewed to assess their impact on outcomes. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care center. SUBJECTS AND METHODS: Patients undergoing injection laryngoplasty from May 2007 to September 2012 were reviewed for possible inclusion. Pre- and postoperative Voice Handicap Index (VHI) scores, as well as senior speech-language pathologists' blinded assessment of voice, were collected for analysis. The final sample included patients who underwent injection laryngoplasty for unilateral vocal fold paralysis, 33 of whom had VHI results and 37 of whom had voice recordings. Additional data were obtained, including technique and timing of injection. RESULTS: Analysis was performed on those patients above with VHI and perceptual voice grades before and at least 6 months following injection. Mean VHI improved by 28.7 points at 6 to 12 months and 22.8 points at >12 months (P = .001). Mean perceptual voice grades improved by 17.6 points at 6 to 12 months and 16.3 points at >12 months (P < .001). No statistically significant difference was found with technique or time to injection. CONCLUSION: Micronized acellular dermis is a safe injectable that improved both patient-completed voice ratings and blinded reviewer voice gradings at intermediate and long-term follow-up. Further investigation may be warranted regarding technique and timing of injection. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/26932966/Injection_Laryngoplasty_Using_Micronized_Acellular_Dermis_for_Vocal_Fold_Paralysis:_Long_term_Voice_Outcomes_ L2 - https://journals.sagepub.com/doi/10.1177/0194599816630971?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -