Long‐term Effects of Micronized Alloderm Injection for Unilateral Vocal Fold Paralysis

Abstract

Results: Twenty patients (7 male, 13 female; 14 with left-sided paralysis, 6 with right-sided paralysis) were identified in the study population. Cymetra injection was performed an average of 45.1 months after onset of vocal fold paralysis (range -216 months), and average follow-up postinjection was 11.2 (range -35) months. Comparing pre-and postoperative measures, voice quality (P < .0001), glottal closure (P < .0001), and degree of vocal fold bowing (P < .0001) were all improved by injection. Quality of life measures and patients' self-perceptions of vocal quality were also improved (P < .01). Fifteen (75%) patients showed longlasting results. Eight patients showed improvement for more than 12 months after injection. Conclusion: Cymetra injection laryngoplasty offers improved vocal and vibratory function to patients with unilateral true vocal fold paralysis. The benefits of such medialization may be longer lasting than previously reported, and further long-term study is warranted. Key Words: Vocal fold paralysis, injection laryngoplasty, vocal fold medialization, voice quality, quality of life.

Laryngoplasty With Hyaluronic Acid in Patients With Unilateral Vocal Fold Paralysis

“…In group B, the average phonation time remained stable 6 months after surgery compared with baseline (6.5 ± 5.3 [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] seconds and 6.8 ± 2.6 [5][6][7][8][9][10][11][12] seconds, respectively; P ¼ 0.8; Table 1 and Figure 2). The other objective voice parameters are listed in Table 1 with their P values.…”

“…The duration of the positive effect of collagen varied between 1 month and in some cases longer than 12 months. 18,19 Fat lasts in general for about 6 months, but its resorption rate is difficult to predict and there can be improvement lasting more than 12 months. 20 The viscoelastic properties of Restylane were similar to normal noninjected vocal folds.…”

Phonation threshold pressure predictions using viscoelastic properties up to 1,400 Hz of injectables intended for Reinke's space

“…It is used for vocal fold medialization by injecting it into the lateral lamina propria or muscle. 18 A third material, Hylan B (Genzyme, Ridgefield, NJ), is a cross-linked hyaluronan-based hydrogel. It is a clear, sterile, and nonpyrogenic injectable indicated for dermal injection and is also used as a bulking agent to treat glottic insufficiency.…”

Bioengineering the Vocal Fold: A Review of Mesenchymal Stem Cell Applications

“…These data suggest that a resident MSC population in vocal fold fat injections may contribute to long-term graft survival, which is suspected to occur in 55-100% of patients (McCulloch et al, 2002;Lo Cicero et al, 2008). Commercially available composite materials have also been commonly used in clinic, such as Gelfoam paste (Schramm et al, 1978), Cymetra (Milstein et al, 2005), calcium hydroxylapatite (Rosen et al, 2007), Restylane and Hylaform (Hertegard et al, 2006b). While these materials have all been reported to improve vocal function, they are not traditionally thought to grow and remodel the tissue, as many of them biodegrade in the body.…”