Objectives/Hypothesis: Severe vocal fold lesions such as vocal fold sulcus, scars, and atrophy induce a communication disorder due to severe hoarseness, but a treatment has not been established. Basic fibroblast growth factor (bFGF) therapies by either four-time repeated local injections or regenerative surgery for vocal fold scar and sulcus have previously been reported, and favorable outcomes have been observed. In this study, we modified bFGF therapy using a single of bFGF injection, which may potentially be used in office procedures.Study Design: Retrospective chart review. Methods: Five cases of vocal fold sulcus, six cases of scars, seven cases of paralysis, and 17 cases of atrophy were treated by a local injection of bFGF. The injection regimen involved injecting 50 mg of bFGF dissolved in 0.5 mL saline only once into the superficial lamina propria using a 23-gauge injection needle. Two months to 3 months after the injection, phonological outcomes were evaluated.Results: The maximum phonation time (MPT), mean airflow rate, pitch range, speech fundamental frequency, jitter, and voice handicap index improved significantly after the bFGF injection. Furthermore, improvement in the MPT was significantly greater in patients with (in increasing order) vocal fold atrophy, scar, and paralysis. The improvement in the MPT among all patients was significantly correlated with age; the MPT improved more greatly in younger patients.Conclusions: Regenerative treatments by bFGF injection-even a single injection-effectively improve vocal function in vocal fold lesions.
bFGF injection, an easy method and suitable as an office procedure, significantly improved the hoarseness caused by UVCP. It is expected to be widely adopted and effective adjunctive drugs, and procedures are anticipated to be developed.
Objectives/Hypothesis: In recent years, basic fibroblast growth factor (bFGF) injection has been used in the treatment of aging-related vocal fold atrophy. This injection not only improves closure by increasing the mass of the vocal fold but also improves its viscoelasticity. However, it has been reported that fibroblasts targeted by bFGF treatment decrease in number with age. The purpose of this study was to examine the effects of local injection of bFGF on age-related vocal atrophy as well as the influence of age on phonological outcomes. Study Design: Retrospective chart review. Methods: Fifty-three patients with age-related vocal fold atrophy underwent single injections of bFGF in their vocal folds. Phonological outcomes were evaluated 3 and 6 months after injection by acoustic and aerodynamic measurements. Results: Voice Handicap Index (VHI), maximum phonation time (MPT), jitter, shimmer, and pitch range improved after injection, and the effects continued for 6 months. In those over 70 years of age, VHI and MPT showed improvement at 3 and 6 months after injection. In addition, the degree of improvement in VHI and MPT did not differ significantly between those older than 70 years and those younger than 70 years. Conclusions: Regenerative treatments dependent on bFGF single injection was safe and effective for both early and late elderly patients suffering of vocal fold atrophy.
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