Laryngeal Electromyography-Guided Hyaluronic Acid Vocal Fold Injection for Unilateral Vocal Fold Paralysis

Abstract

Of the 74 patients in this study, 44 (60%) who received a single injection and 16 (22%) who received repeated injections did not require another treatment after long-term follow-up. Laryngeal electromyography-guided hyaluronic acid VF injection is an option for treating UVFP with satisfactory results.

Laryngeal electromyography and prognosis of unilateral vocal fold paralysis—A long‐term prospective study

“…After completion of LEMG signal recording, 1.0 mL of HA Restylane Perlane (Q‐Med, Uppsala, Sweden) was injected via a 26‐gauge injectable needle into the TA muscle to augment the paralyzed vocal fold (see Supporting Video 1 in the online version of this article). In our recent published long‐term follow‐up data of HA injection, about 81% of our patients did not need open laryngeal framework surgery after one (60%) or two and three injections (21%) of HA, with a mean follow‐up of 17.4 months. That simultaneous injection gave our patients an opportunity to have serviceable voice for a long follow‐up duration of immobile vocal fold without permanently fixing the paralyzed vocal fold in the midline with laryngeal framework surgery.…”

“…We made a prognostic prediction promptly after the LEMG and blindly before knowing the outcome of paralyzed vocal fold mobility. Moreover, to treat the patients simultaneously, we used LEMG‐guided hyaluronic acid (HA) vocal fold injection to correct the glottal gap of UVFP . After completion of LEMG signal recording, 1.0 mL of HA Restylane Perlane (Q‐Med, Uppsala, Sweden) was injected via a 26‐gauge injectable needle into the TA muscle to augment the paralyzed vocal fold (see Supporting Video 1 in the online version of this article).…”

Early‐injection laryngoplasty may lower risk of thyroplasty: A systematic review and meta‐analysis

“…During this waiting period, the two management options are observation or temporary‐injection laryngoplasty . Injection laryngoplasty can be performed in the office or in the operating room at very low risk to the patient .…”

Long‐term outcomes in unilateral vocal fold paralysis patients

“…First reported by Omori and colleagues, this measurement reports the maximum glottic gap area appreciated during sustained phonation when referenced against the length of the membranous true vocal fold . Although there remains slight subjectivity while capturing the moment of maximum glottic closure during videolaryngostroboscopy, this method has gained popularity as a relatively robust and objective tool to assess maximum glottic closure . Fang et al recently utilized NGGA as a method by which to predict which patients might go on to require PM for a diagnosis of UVFP.…”