A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience

Chandran, Dhinashini; Woods, Charmaine M.; Ullah, Shahid; Ooi, Eng H.; Athanasiadis, Theodore

doi:10.1017/s0022215116009221

Cited by 14 publications

(10 citation statements)

References 24 publications

(17 reference statements)

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“…In fact, multiple authors have reported on the safety and efficacy of in-office techniques used as alternatives to examination and biopsy under anaesthesia 3 – 6 . Lippert et al .…”

Section: Discussionmentioning

confidence: 99%

Reviewing indications for panendoscopy in the investigation of head and neck squamous cell carcinoma

et al. 2018

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BackgroundThe role of panendoscopy in the modern investigation of head and neck cancer is changing with the development of improved radiological techniques, in-office biopsy capabilities and the low rate of synchronous primary tumours. This study aimed to review the indications for panendoscopy in the investigation of newly diagnosed head and neck cancer.MethodA retrospective review was conducted of 186 patients with newly diagnosed head and neck cancer, between January 2014 and December 2015, at two tertiary centres.ResultsObtaining a tissue diagnosis was the most common indication for panendoscopy (65 per cent), followed by surgical planning including transoral robotic surgery suitability assessment (22.6 per cent), and the investigation of carcinoma of an unknown primary (11.3 per cent). Two synchronous primary tumours were identified, generating a yield of 1.1 per cent.ConclusionPanendoscopy remains integral in the assessment of transoral robotic surgery suitability. Refining indications for modern panendoscopy could reduce the need for this procedure in this cohort of patients.

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“…In fact, multiple authors have reported on the safety and efficacy of in-office techniques used as alternatives to examination and biopsy under anaesthesia 3 – 6 . Lippert et al .…”

Section: Discussionmentioning

confidence: 99%

Reviewing indications for panendoscopy in the investigation of head and neck squamous cell carcinoma

et al. 2018

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“…, 2 Current evidence indicates comparable clinical outcomes and complication rates for procedures such as injection laryngoplasty and oesophagoscopy that are performed in-office under LA and in the operating theatre using GA 1 5 A study recently conducted in Australia showed similar voice outcomes with low complication rates for injection laryngoplasty performed under both anaesthetic modalities 6 . Despite comparable outcomes, major advantages of injection laryngoplasty under LA are the ability to titrate the amount of injection material and procedural precision when injecting into the vocal fold, as the patient is able to phonate during the procedure 7 .…”

Section: Introductionmentioning

confidence: 98%

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective

et al. 2017

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“…In his report of 34 patients, there was significant improvement in the perceptual parameters, acoustic measures, mucosal wave, and glottic closure post-operatively. Chandran et al 20 reported the Australian experience of 34 injections performed under either local or general anesthesia with improvement in the VHI-10, all perceptual parameters except asthenia, and a less than 10% complication rate. Barbu et al 21 in their investigation on the feasibility of bed side injection laryngoplasty using the transoral approach in the immediate post-operative period have reported advancement in oral intake in 70 percent of patients, thus supporting the importance of early intervention.…”

Section: Discussionmentioning

confidence: 99%

Voice outcome measures after flexible endoscopic injection laryngoplasty

Hamdan

Rizk

Khalifee

et al. 2018

World j. otorhinolaryngol.-head neck surg.

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ObjectiveTo report voice outcome measures after injection laryngoplasty using the transnasal or transoral flexible endoscopic technique.MethodsA retrospective review of all patients who underwent flexible endoscopic injection laryngoplasty between June 2010 and August 2016 was carried out. Only those patients who had pre- and post-injection voice outcome measures recorded were included. Voice outcome measures recorded included perceptual voice evaluation using GRBAS, Voice Handicap Index-10 (VHI-10), maximum phonation time (MPT) and closed quotient (CQ) before and after treatment.ResultsForty-six patients were identified, of which 32 had pre- and post-injection voice outcome measures recorded. There were 19 males and 13 females. The mean age was 56.97 years (range 20–86 years) and the most common indication was unilateral vocal fold paralysis. Thirteen patients had a transnasal flexible endoscopic injection), while 19 patients were injected transorally. Following injection laryngoplasty, there was significant improvement in the mean grade of dysphonia (2.81 vs. 1.22, P < 0.01, roughness (2.44 vs. 1.34, P < 0.01), breathiness (2.72 vs. 1.13, P < 0.01), asthenia (2.78 vs. 1.06, P < 0.01), and strain (2.44 vs. 1.19, P < 0.01), MPT (3.85 s vs. 9.85 s, P < 0.01) and mean CQ (0.19 vs. 0.46, P < 0.01). There was also a decrease in the mean VHI-10 score (33.31 vs. 7.94, P < 0.01).Conclusions: Patients achieved significant improvement in both subjective and objective voice measures after flexible endoscopic injection laryngoplasty via the nasal or transoral route. Voice outcomes were comparable to those reported for other approaches. This technique provides an alternative approach for the management of patients with vocal fold paralysis or glottal insufficiency.

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A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience

Abstract: Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended.

Cited by 14 publications

References 24 publications

Reviewing indications for panendoscopy in the investigation of head and neck squamous cell carcinoma

Reviewing indications for panendoscopy in the investigation of head and neck squamous cell carcinoma

Cost analysis of injection laryngoplasty performed under local anaesthesia versus general anaesthesia: an Australian perspective

Voice outcome measures after flexible endoscopic injection laryngoplasty

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