Functional assessment of glottal insufficiency treated by hyaluronic acid injection: Retrospective 20-case series

Dorbeau, C.; Marmouset, F.; Lescanne, E.; Bakhos, D.; Morinière, S.

doi:10.1016/j.anorl.2016.11.006

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…Glottic insufficiency can impact a patient's quality of life in many ways, including dysphonia, aspiration risks, or airway compromise [24]. VFIs are often used as a safe, temporizing treatment for glottic insufficiency to improve voice outcomes [2][3][4]. Patient satisfaction with VFIs are reflected in the low DRS scores reported in this study; the majority of our patients reported no (61.0%) or mild (24.3%) decisional regret (Fig.…”

Section: Discussionmentioning

confidence: 73%

“…They were first introduced in 1911 and are now commonly completed as office-based procedures rather than operative procedures requiring general anesthetic [ 1 , 2 ]. While in-office VFIs have high completion rates with minimal complications and improve voice outcomes [ 3 , 4 ], there is a paucity of research on patients’ decision-making process with this treatment option.…”

Section: Introductionmentioning

confidence: 99%

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Do patients regret having in-office vocal fold injections for glottic insufficiency?

Liu

2023

Journal of Otolaryngology - Head & Neck Surgery

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Background In-office vocal fold injections (VFI) are an effective treatment for glottic insufficiency. The primary objective of this study was to assess if patients reported decisional regret after VFI. Secondary objectives included determining if variables were associated with lower decisional regret. Methods Case–control study of patients who underwent in-office VFIs for glottic insufficiency from August 2017 to December 2019 at a tertiary laryngology clinic. Participants completed the validated Decision Regret Scale (DRS). Demographic data, clinician’s perceptual analysis with GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain), and patient’s self-reported Voice Handicap Index-10 (VHI-10) were analyzed. Nonparametric tests as well as univariate and multiple logistics regression were performed. Results Of patients eligible, 75% (136/182) completed the DRS (mean age 65.4 years (SD 13.9), 58.1% male). Eighty-three (61.0%) reported no decisional regret, thirty-three (24.3%) reported mild decisional regret, and twenty (14.7%) reported moderate to strong decisional regret. Improvement in most recent VHI-10 (Kendall correlation coefficient tau = 0.156, p = 0.029), Grade of voice (tau = 0.236, p value = 0.002) and Breathiness of voice (tau = 0.150, p = 0.044) were associated with lower DRS. Multivariate logistics regression results showed that the change in Grade of voice (OR 9.9, p < 0.01), Roughness (OR 0.2, p < 0.01) and Breathiness (OR 0.2, p < 0.03) were significantly associated with DRS. Conclusion The majority of patients had no or mild decisional regret after in-office VFI for glottic insufficiency. Both patients who reported less vocal handicap after VFI and clinician-noted improvements in perceptual evaluation of voice after VFI were associated with significantly lower decisional regret. Graphical Abstract

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Do patients regret having in-office vocal fold injections for glottic insufficiency?

Liu

2023

Journal of Otolaryngology - Head & Neck Surgery

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“…Our mean volume of 0.72 mL was similar to the 0.44 to 0.65 mL reported by others for HA VFIs. 24,25 LEVFI does not aim to over-inject and cause a strained voice, which may explain a higher than expected reinjection rate at follow-up. It is difficult for the authors to definitively ascertain if repeat injections were done because of resorption of HA or because patients were under-injected to begin with.…”

Section: Discussionmentioning

confidence: 94%

Laryngeal Electromyography-Guided Hyaluronic Acid Vocal Fold Injections for Glottic Insufficiency

Liu

Singer

Lee

et al. 2020

Ann Otol Rhinol Laryngol

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Objectives: To assess voice outcomes using the novel technique of in-office laryngeal electromyography-guided vocal fold injections (LEVFI) with hyaluronic acid to treat glottal insufficiency. Secondary objectives included determining the complication/completion rates and if any factors were associated with improved voice outcomes. Methods: Retrospective review of patients who received their first LEVFI from August 2017 to December 2018. Three- and six-month voice outcomes were assessed. Outcomes included voice handicap index-10 (VHI-10), maximum phonation time (MPT), perceptual analysis of voice (GRBAS), fundamental frequency, and stroboscopy. Results: Of the 121 eligible patients (55.4% male, age 63.7 years), 94 (77.7%) had complete 3-month data and 59 (48.8%) had complete 6-month data. VHI-10 was significantly improved from 25.7 ± 7.5 to 20.9 ± 10.9 at 3 months ( P < .001) and to 19.1 ± 11.5 at 6 months ( P < .001). MPT improved from 6.2 ± 5.4 seconds to 9.4 ± 7.1 seconds at 3 months ( P < .001) and to 11.3 ± 8.2 seconds at 6 months ( P < .001). GRBAS was improved in 74.8% of patients ([65.2, 82.8] 95% CI) at 3 months and 80.8% ([69.9, 89.1]) 95% CI) at 6 months. Stroboscopy showed a glottic gap improvement in 74.8% of patients ([65.8, 82.4] 95% CI) at 3 months and in 80.3% ([65.9, 88.5] 95% CI) at 6 months. Fundamental frequency was unchanged, as expected. Multivariate analysis reported that no factors were associated with better voice outcomes. Overall, 177/181 (97.8%) injections were completed. There were no complications. Conclusion: In-office LEVFI is an effective, novel technique to treat glottic insufficiency with improved voice outcomes, high completion rate, and no significant complications.

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“…The study concluded that HA injection is an effective treatment for glottal insufficiency, and it can improve both objective and subjective vocal parameters even at the postoperative sixth month. 24 In another study of 50 patients, acoustic analysis and VHI-10 questionnaire results were evaluated after HA injections. The study found a significant improvement in vocal fold functions 4 weeks after the injection laryngoplasty.…”

Section: Discussionmentioning

confidence: 99%

The Long Term Results of Hyaluronic Acid/Dextranomer Injection Laryngoplasty in Unilateral Vocal Fold Paralysis

Alaskarov,

Batıoğlu-Karaaltın,

Erdur

et al. 2024

Ann Otol Rhinol Laryngol

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Objective: This study was conducted to present the long-term functional outcomes of injection laryngoplasty (IL) with hyaluronic acid/dextranomer (HA/D) in unilateral vocal fold paralysis (UVFP). Methods: A total of 40 patients who underwent HA/D injection for UVFP were enrolled. The acoustic analysis of the voice was evaluated with jitter percentage, shimmer percentage, maximum phonation time, harmonics-to-noise ratio, and fundamental frequency. The psychosocial effect of the voice was determined using the Voice Handicap Index-10. Fiberoptic endoscopic evaluation of swallowing was performed and 2 scales were used for quantification: a modified penetration-aspiration scale and a dysphagia score. All measurements were performed at preoperative day and postoperative months 1, 6, and 24. Results: A statistically significant improvement was observed for all of the evaluated parameters except the maximum phonation time for postoperative months 1, 6, and 24 ( P < .05). In the evaluation of the maximum phonation time, although there was a significant improvement for the postoperative months 1 and 6, no significant difference was observed between the postoperative 24th month and the preoperative value. Conclusions: HA/D injection laryngoplasty is an effective method both in the short- and long-term to improve voice and swallowing functions in patients with UVFP.

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Functional assessment of glottal insufficiency treated by hyaluronic acid injection: Retrospective 20-case series

Abstract: Hyaluronic acid injection was effective in treating glottal failure, improving objective and subjective vocal parameters, which remained satisfactory even 6 months postoperatively.

Cited by 8 publications

References 15 publications

Do patients regret having in-office vocal fold injections for glottic insufficiency?

Do patients regret having in-office vocal fold injections for glottic insufficiency?

Laryngeal Electromyography-Guided Hyaluronic Acid Vocal Fold Injections for Glottic Insufficiency

The Long Term Results of Hyaluronic Acid/Dextranomer Injection Laryngoplasty in Unilateral Vocal Fold Paralysis

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