orabase and Laryngeal-Diseases

Clinical indications for vocal fold injection augmentation (VFI) are expanding. Prior studies demonstrate the benefit of trial VFI for select causes of glottic insufficiency. No studies have examined trial VFI for glottic insufficiency resulting from true vocal fold (TVF) scar.. Retrospective chart review of patients who underwent trial VFI for a dominant pathology of TVF scar causing dysphonia. Patients who subsequently underwent durable augmentation were identified. The primary study outcome was the difference in Voice Handicap Index-10 (VHI-10) score from pretrial VFI to post-durable augmentation.. Twenty-eight patients underwent trial VFI for TVF scar, 22 of whom reported a positive response. Fifteen of 22 subjects who underwent durable augmentation had viable data for analysis. Mean VHI-10 improved from 26.9 to 18.6 ( P < .05), for a delta VHI-10 of 8.3, or 30.9% improvement. Twelve of the 15 (80%) showed a clinically significant improvement (delta VHI-10 >5).. A trial VFI is a potentially useful, low-risk procedure that appears to help the patient and clinician identify when global augmentation might improve the voice when vocal fold scar is present. Patients who reported successful trial VFI often demonstrated significant improvement in their VHI-10 after subsequent durable augmentation.

Topics: Adult; Aged; Aged, 80 and over; Carboxymethylcellulose Sodium; Cicatrix; Dysphonia; Female; Follow-Up Studies; Humans; Injections; Laryngeal Diseases; Male; Middle Aged; Patient Satisfaction; Retrospective Studies; Vocal Cords; Voice Quality

Trial vocal fold injection (TVFI) may be used prior to permanent medialization when voice outcome is uncertain. We aimed to determine whether voice outcomes of TVFI are predictive of, or correlate with outcomes after type I Gore-Tex medialization thyroplasty (GMT) in patients with nonparalytic glottic incompetence (GI).. Thirty-five patients with nonparalytic GI who underwent TVFI followed by GMT were retrospectively reviewed. Change in voice-related quality of life (VRQOL) after TVFI was compared to change in VRQOL 3 to 9 months after GMT. Similar comparisons were made for change in glottal function index (GFI) and change in grade, roughness, breathiness, asthenia, and strain (GRBAS). Sample correlation coefficients were calculated.. Change in VRQOL after TVFI showed good correlation with change in VRQOL after GMT, r = 0.55. Change in GFI after TVFI showed strong correlation with change in GFI after GMT, r = 0.74. Change in GRBAS after TVFI showed excellent correlation with change in GRBAS after GMT, r = 0.90.. The TVFI is a useful tool in nonparalytic GI when outcomes from glottic closure procedures are not clear. Voice outcome measures after TVFI strongly correlate with outcomes from GMT. These data may be used to more confidently counsel patients regarding their predicted outcomes of permanent medialization.

Topics: Atrophy; Carboxymethylcellulose Sodium; Cicatrix; Collagen; Female; Gelatin Sponge, Absorbable; Glottis; Humans; Laryngeal Diseases; Laryngoplasty; Male; Middle Aged; Polytetrafluoroethylene; Prognosis; Quality of Life; Retrospective Studies; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords; Voice

To compare voice outcomes after vocal fold augmentation using a trial (temporary) vocal fold injection (VFI) versus long-term augmentation in patients diagnosed with vocal fold atrophy.. Retrospective, single-blinded study.. Nineteen patients diagnosed with vocal fold atrophy underwent trial VFI and subsequent long-term augmentation. Voice Handicap Index-10, acoustic, and aerodynamic measures were analyzed following trial and long-term augmentation procedures.. Forty-two percent (8/19) of patients had a good response to trial VFI (P < .0001); 58% (11/19) had a poor response to trial VFI (P = .95). Of the patients with good response to trial VFI, 75% (6/8) also had good response to long-term augmentation (P = .006), but 25% (2/8) reported a poor response to long-term treatment. Of the patients who had a poor response to trial VFI, 55% (6/11) also had a poor response to long-term treatment, but 45% (5/11) of patients reported good response after long-term augmentation.. This is the first study to provide comparative voice outcomes using both trial VFI and long-term augmentation for vocal fold atrophy. Additional critical evaluation of the value of trial VFI for vocal fold atrophy patients is suggested.

Topics: Aged; Aged, 80 and over; Atrophy; Carboxymethylcellulose Sodium; Female; Follow-Up Studies; Humans; Hyaluronic Acid; Injections, Intralesional; Laryngeal Diseases; Laryngoscopy; Male; Middle Aged; Retrospective Studies; Single-Blind Method; Time Factors; Treatment Outcome; Vocal Cords; Voice Disorders; Voice Quality