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Additional Injection Laryngoplasty for Patients With Unilateral Vocal Fold Paralysis.
Laryngoscope. 2020 Feb 14 [Online ahead of print]L

Abstract

OBJECTIVES

In case of insufficient voice improvement after injection laryngoplasty (IL), additional IL will be one of the next option of treatments. However, little is known about the voice outcomes regarding an additional IL.

STUDY DESIGN

Retrospective comparative study in single institution.

METHODS

We enrolled the patients of unilateral vocal fold paralysis (UVFP), who received IL (N = 76) twice because of insufficient voice improvement. The etiologies of UVFP were related with thoracic and esophageal surgery (51.3%), neck surgery (30.3%), skull base surgery (7.9%), or unknown (10.5%). The subjective and objective voice parameters were collected before and after (mean: 5.3 months) each IL.

RESULTS

Aspiration, maximum phonation time (MPT), jitter percentage, shimmer percentage, and noise to harmonic ratio (NHR) were significantly improved after both the first and second rounds of IL (P < .05). Voice handicap index (VHI)-30 was also significantly improved after both the first and second rounds of IL (P < .001). Regarding GRBAS score, overall grade of dysphonia (G), roughness (R), and breathiness (B) were significantly improved after the first IL, but only G and R after the second IL (P < .05). In comparison between postprocedural voice parameters of the first and second ILs, MPT was significantly improved from 5.5 ± 3.5 seconds to 7.3 ± 7.5 seconds (P = .001). Grade of dysphonia (1.9 ± 0.8) and breathiness (1.7 ± 0.9) of post-first IL were significantly (P < .001) improved to those of post-second IL (1.3 ± 0.7 and 1.2 ± 0.7, respectively). VHI-30 of post-first IL (72.0 ± 20) was significantly improved (P < .001) to those of the second IL (57.2 ± 23.7).

CONCLUSIONS

In selected patients, additional IL could provide further improvement of voice in patient who had unsatisfactory voice results despite of initial IL.

LEVEL OF EVIDENCE

4 Laryngoscope, 2020.

Authors+Show Affiliations

Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Otorhinolaryngology-Head and Neck Surgery, Gyeongsang National University Hospital, Jinju, Republic of Korea.Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32057117

Citation

Choi, Nayeon, et al. "Additional Injection Laryngoplasty for Patients With Unilateral Vocal Fold Paralysis." The Laryngoscope, 2020.
Choi N, Won S, Jin H, et al. Additional Injection Laryngoplasty for Patients With Unilateral Vocal Fold Paralysis. Laryngoscope. 2020.
Choi, N., Won, S., Jin, H., Kim, H. J., Park, W., & Son, Y. I. (2020). Additional Injection Laryngoplasty for Patients With Unilateral Vocal Fold Paralysis. The Laryngoscope. https://doi.org/10.1002/lary.28567
Choi N, et al. Additional Injection Laryngoplasty for Patients With Unilateral Vocal Fold Paralysis. Laryngoscope. 2020 Feb 14; PubMed PMID: 32057117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additional Injection Laryngoplasty for Patients With Unilateral Vocal Fold Paralysis. AU - Choi,Nayeon, AU - Won,Seongjun, AU - Jin,Hokyung, AU - Kim,Hack Jung, AU - Park,Woori, AU - Son,Young-Ik, Y1 - 2020/02/14/ PY - 2019/09/05/received PY - 2020/01/12/revised PY - 2020/01/29/accepted PY - 2020/2/15/entrez KW - Vocal fold paralysis KW - additional KW - injection laryngoplasty KW - multiple JF - The Laryngoscope JO - Laryngoscope N2 - OBJECTIVES: In case of insufficient voice improvement after injection laryngoplasty (IL), additional IL will be one of the next option of treatments. However, little is known about the voice outcomes regarding an additional IL. STUDY DESIGN: Retrospective comparative study in single institution. METHODS: We enrolled the patients of unilateral vocal fold paralysis (UVFP), who received IL (N = 76) twice because of insufficient voice improvement. The etiologies of UVFP were related with thoracic and esophageal surgery (51.3%), neck surgery (30.3%), skull base surgery (7.9%), or unknown (10.5%). The subjective and objective voice parameters were collected before and after (mean: 5.3 months) each IL. RESULTS: Aspiration, maximum phonation time (MPT), jitter percentage, shimmer percentage, and noise to harmonic ratio (NHR) were significantly improved after both the first and second rounds of IL (P < .05). Voice handicap index (VHI)-30 was also significantly improved after both the first and second rounds of IL (P < .001). Regarding GRBAS score, overall grade of dysphonia (G), roughness (R), and breathiness (B) were significantly improved after the first IL, but only G and R after the second IL (P < .05). In comparison between postprocedural voice parameters of the first and second ILs, MPT was significantly improved from 5.5 ± 3.5 seconds to 7.3 ± 7.5 seconds (P = .001). Grade of dysphonia (1.9 ± 0.8) and breathiness (1.7 ± 0.9) of post-first IL were significantly (P < .001) improved to those of post-second IL (1.3 ± 0.7 and 1.2 ± 0.7, respectively). VHI-30 of post-first IL (72.0 ± 20) was significantly improved (P < .001) to those of the second IL (57.2 ± 23.7). CONCLUSIONS: In selected patients, additional IL could provide further improvement of voice in patient who had unsatisfactory voice results despite of initial IL. LEVEL OF EVIDENCE: 4 Laryngoscope, 2020. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/32057117/Additional_Injection_Laryngoplasty_for_Patients_With_Unilateral_Vocal_Fold_Paralysis L2 - https://doi.org/10.1002/lary.28567 DB - PRIME DP - Unbound Medicine ER -
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