Background: Office-based injection laryngoplasty is a surgical procedure that becomes more popular for vocal fold (VF) augmentation. Hydroxylapatite (Radiesse) is used to narrow the glottal gap in cases with glottal insufficiency. Objective: To assess voice outcome and patient's quality of life in selected group of dysphonic patients using office-based hydroxylapatite injection under local anesthesia in cases with glottal insufficiency. Materials and methods: Forty-one patients with different voice disorders, namely sulcus vocalis, unilateral VF immobility, and VF atrophy were selected. All patients underwent office-based injection of hydroxylapatite under local anesthesia. All patients were evaluated by using auditory perceptual analysis, laryngeal videostroboscope (LVS), acoustic analysis, and voice handicap index (VHI) preoperatively and 3 months postoperatively. Results: Improvement in glottal gap in all groups of patients was measured by LVS examination. Also, there was significant improvement in acoustic correlates of dysphonia, namely jitter%, shimmer%, noise to harmonic ratio (NHR), and maximum phonation time (MPT) in patients with unilateral VF immobility and VF atrophy. Also improved quality postinjection was reported in all groups measured by VHI. Conclusion: Office-based injection laryngoplasty with hydroxylapatite is a reliable and effective procedure in management of mild and moderate glottal gap because of unilateral VF immobility and VF atrophy.
Phua CQ, Mahalingappa Y, Homer J, et al. Injection laryngoplasty. Otorhinolaryngologist 2013;6:111–118.
Bihari A, Meszaros K, Remenyi A, et al. Voice quality improvement after management of unilateral vocal cord paralysis with different techniques. Eur Arch Otorhinolaryngol 2006;263(12):1115–1120. DOI: 10.1007/s00405-006-0116-9.
Amin MR. Thyrohyoid approach for vocal fold augmentation. Ann Otol Rhinol Laryngol 2006;115(9):699–702. DOI: 10.1177/000348940611500909.
Mathison CC, Villari CR, Kelin AM, et al. Comparison of outcomes and complications between awake and asleep injection laryngoplasty: a case-control study. Laryngoscope 2009;119(7):1417–1423. DOI: 10.1002/lary.20485.
Hertegard S, Hallen L, Laurent C, et al. Cross-linked hyaluronan versus collagen for injection treatment of glottal insufficiency: 2-year follow-up. Acta Otolaryngol 2004;124(10):1208–1214. DOI: 10.1080/00016480410017701.
Kim YS, Choi JW, Park JK, et al. Efficiency and durability of hyaluronic acid of different particle sizes as an injectable material for VF augmentation. Acta Otolaryngol 2015;135(12):1311–1318. DOI: 10.3109/00016489.2015.1070966.
Yılmaz T. Sulcus vocalis: excision, primary suture and medialization laryngoplasty: personal experience with 44 cases. Eur Arch Otorhinolaryngol 2012;269(11):2381–2389. DOI: 10.1007/s00405-012-2058-8.
Ford CN, Inagi K, Khidr A, et al. Sulcus vocalis: a rational analytical approach to diagnosis and management. Ann Otol Rhinol Laryngol 1996;105(3):189–200. DOI: 10.1177/000348949610500304.
Singh JM, Kwartowitz G. Vocal Fold Paralysis Unilateral. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519060/.
Fang TJ, Li HY, Gliklich RE, et al. Outcomes of fat injection laryngoplasty in unilateral vocal cord paralysis. Arch Otolaryngol Head Neck Surg 2010;136(5):457–462. DOI: 10.1001/archoto.2010.42.
Kaneko M, Hirano S, Tateya I, et al. Multidimensional analysis on the effect of vocal function exercises on aged vocal fold atrophy. J Voice 2015;29(5):638–644. DOI: 10.1016/j.jvoice.2014.10.017.
Kotby MN. The accent method of voice therapy. Singular Publishing Group, Inc.; 1995. pp. 3–21.
Malki KH, Mesallam TA, Farahat M, et al. Validation and cultural modification of Arabic voice handicap index. Eur Arch Otorhinolaryngol 2010;267(11):1743–1751. DOI: 10.1007/s00405-010-1296-x.
Dursun G, Boynukalin S, Ozgursoy OB, et al. Long-term results of different treatment modalities for glottic insufficiency. Am J Otolaryngol 2008;29(1):7–12. DOI: 10.1016/j.amjoto.2006.12.001.
Lee A, Sulica L, Aylward A, et al. Sulcus vocalis; a new histopathological paradigm based on a reevaluation of histology. Laryngoscope 2016;126(6):1397–1403. DOI: 10.1002/lary.25732.
Schaeffer N, Knudsen M, Small A. Multidimensional voice data on participants with perceptually normal voices from ages 60 to 80: a preliminary acoustic reference for the elderly population. J Voice 2015;29(5):631–637. DOI: 10.1016/j.jvoice.2014.10.003.
Miaśkiewicz B, Szkiełkowska A, Panasiewicz A, et al. Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients. Eur Arch Otorhinolaryngol 2018;275(11):2763–2771. DOI: 10.1007/s00405-018-5040-2.