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- Title
Bilateral trial vocal fold injection with hyaluronic acid in patients with vocal fold atrophy with or without sulcus.
- Authors
van den Broek, Emke M. J. M.; Heijnen, Bas J.; Hendriksma, Martine; Langeveld, Antonius P. M.; van Benthem, Peter Paul G.; Sjögren, Elisabeth V.
- Abstract
Purpose: To evaluate the outcome of bilateral trial vocal fold injection (VFI) with hyaluronic acid in patients with vocal fold atrophy ± sulcus and to assess the predictive value of trial VFI on the outcome of durable medialization procedure. Methods: Voice data collected according to a standardized protocol before and one month after trial VFI of 68 patients with vocal fold atrophy (30) and atrophy with sulcus (38) were analyzed. Voice Handicap Index (VHI)-30 was compared to the outcome of a durable medialization at 3 and 12 months. Results: The overall VHI-30 improvement was 16.8 points (from 49.9 to 33.1), which was statistically significant and clinically relevant. 57.8% of the patients experienced enough subjective benefit after trial VFI to undergo durable medialization. Of the patients that experienced subjective benefit 62% had a clinically relevant improvement in VHI-30. There was no relevant change in other parameters and no difference between ± sulcus. After durable medialization 90–94% of the patients had VHI-30 scores similar to or better than post-trial VFI. Conclusion: The majority of patients experience subjective improvement after bilateral trial VFI indicating that medialization is a valid treatment option for patients with vocal fold atrophy ± sulcus. The VHI-30 only partially overlaps with patients' subjective evaluation and does not predict which patients will experience subjective improvement. It is, however, predictive for VHI-30 outcome after durable medialization. The aerodynamic and acoustic parameters showed no relevant change. Further identification of voice assessment parameters accurately reflecting the subjective experience of these patients is warranted.
- Subjects
VOCAL cords; LARYNGOPLASTY; HYALURONIC acid; ATROPHY; INJECTIONS
- Publication
European Archives of Oto-Rhino-Laryngology, 2019, Vol 276, Issue 5, p1413
- ISSN
0937-4477
- Publication type
Article
- DOI
10.1007/s00405-019-05347-2