Regenerative phonosurgical treatments for vocal fold scar and sulcus with basic fibroblast growth factor

Hirano, Shigeru; Mizuta, Masanobu; Kaneko, Mitsuaki; Tateya, Ichiro; Kanemaru, S.; Ito, Juichi

doi:10.1002/lary.24092

Cited by 44 publications

(64 citation statements)

References 32 publications

(54 reference statements)

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“…A significant difference was observed between the preinjective and postinjective values of MPT, MFR, PR, jitter, SFF, and VHI. These results indicates that the single injection method has a similar effect as the four‐time repeated injection method or regenerative surgery used by Hirano et al for severe hoarseness due to vocal fold lesions or vocal fold paralysis. It is unclear why a single injection method has a similar effect as the four‐time injection method or regenerative surgery.…”

Section: Discussionsupporting

confidence: 63%

“…The fundamental therapy for these diseases is conservative voice therapy; however, this approach is sometimes ineffective for severe hoarseness . Several surgical approaches have been attempted, but the surgical outcome varies because it depends on an unpredictable healing process . Thus, it is necessary to develop a new type of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…They also reported that HGF and bFGF have therapeutic potential for vocal fold lesions . Based on these experimental data, a clinical trial using bFGF was initiated . This clinical trial consisted of local four‐time injection of bFGF and regenerative surgery using bFGF.…”

Section: Discussionmentioning

confidence: 99%

“…Growth factor therapy is considered to be a “trigger” for jump‐starting biological processes; this may explain why only a few injection of bFGF solution achieved such drastic effects in most cases . Although overlap with part of their studies, there are three possible reasons. First, we injected each vocal fold with a fivefold higher amount of bFGF than was used in the Hirano regimen.…”

Section: Discussionmentioning

confidence: 99%

“…Various surgical attempts have been performed for these cases, such as the dissection or excision of the lesion, the slicing technique, carbon dioxide laser ablation with collagen injection, and fat implant and fascia implant to stimulate regeneration of the SLP . However, a particular treatment has not been established, because the wound‐healing process for regeneration is unpredictable …”

Section: Introductionmentioning

confidence: 99%

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Single injection of basic fibroblast growth factor to treat severe vocal fold lesions and vocal fold paralysis

et al. 2015

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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.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Single injection of basic fibroblast growth factor to treat severe vocal fold lesions and vocal fold paralysis

et al. 2015

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In vitroevaluation of a basic fibroblast growth factor‐containing hydrogel toward vocal fold lamina propria scar treatment

et al. 2017

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Scarring of the vocal fold lamina propria can lead to debilitating voice disorders that can significantly impair quality of life. The reduced pliability of the scar tissue-which diminishes proper vocal fold vibratory efficiency-results in part from abnormal extracellular matrix (ECM) deposition by vocal fold fibroblasts (VFF) that have taken on a fibrotic phenotype. To address this issue, bioactive materials containing cytokines and/or growth factors may provide a platform to transition fibrotic VFF within the scarred tissue toward an anti-fibrotic phenotype, thereby improving the quality of ECM within the scar tissue. However, for such an approach to be most effective, the acute host response resulting from biomaterial insertion/injection likely also needs to be considered. The goal of the present work was to evaluate the anti-fibrotic and anti-inflammatory capacity of an injectable hydrogel containing tethered basic fibroblast growth factor (bFGF) in the dual context of scar and biomaterial-induced acute inflammation. An in vitro co-culture system was utilized containing both activated, fibrotic VFF and activated, pro-inflammatory macrophages (MΦ) within a 3D poly(ethylene glycol) diacrylate (PEGDA) hydrogel containing tethered bFGF. Following 72 h of culture, alterations in VFF and macrophage phenotype were evaluated relative to mono-culture and co-culture controls. In our co-culture system, bFGF reduced the production of fibrotic markers collagen type I, α smooth muscle actin, and biglycan by activated VFF and promoted wound-healing/anti-inflammatory marker expression in activated MΦ. Cumulatively, these data indicate that bFGF-containing hydrogels warrant further investigation for the treatment of vocal fold lamina propria scar. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1258-1267, 2018.

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Stem cell approaches for vocal fold regeneration

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Long²,

Gugatschka

et al. 2016

The Laryngoscope

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Regenerative phonosurgical treatments for vocal fold scar and sulcus with basic fibroblast growth factor

Abstract: Regenerative treatments using bFGF has shown to be effective for improvement of vocal function in scar and sulcus.

Cited by 44 publications

References 32 publications

Single injection of basic fibroblast growth factor to treat severe vocal fold lesions and vocal fold paralysis

Single injection of basic fibroblast growth factor to treat severe vocal fold lesions and vocal fold paralysis

In vitroevaluation of a basic fibroblast growth factor‐containing hydrogel toward vocal fold lamina propria scar treatment

Stem cell approaches for vocal fold regeneration

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