Injection laryngoplasty outcomes in vocal fold paralysis using calcium hydroxylapatite

Yıl 2014, Cilt: 24 Sayı: 5, 271 - 275, 15.10.2014

Pelin Koçdor Özlem E. Tulunay Uğur

Öz

Objectives: This study aims to evaluate our injection laryngoplasty experience in patients with unilateral vocal fold paralysis. Patients and Methods: Sixty-eight patients 32 males, 36 females; mean age 59.5 years; range 27 to 86 years who were diagnosed with unilateral vocal fold paralysis at our clinic and who underwent injection laryngoplasty using calcium hydroxylapatite between January 2005 and June 2012 were included in this study. Results: Mean follow-up period was 36 weeks range 0-340.4 weeks . Data of 29 patients with post-injection Voice Handicap Index VHI scores were retrospectively analyzed. Of these patients, 16 55% were female, and the mean patient age was 60 range 27 to 86 years . Seventeen patients underwent suspension laryngoscopy in the operating room, 12 patients underwent in-office percutaneous injection. Post-injection mean VHI score was 36.7 range 4 to 87 . Percutaneous injection laryngoplasty was performed to half of the 20 patients with pre- and post-injection VHI data. Mean VHI scores of these 20 patients improved by 27.9 points. Mean VHI score improved by 35.1 points in the percutaneous group, and by 20.7 points in the suspension group p=0.29 . Post-injection VHI score of one patient with lung cancer decreased, as his general health deteriorated. Conclusion: This study supports injection laryngoplasty in vocal fold paralysis. Calcium hydroxylapatite is a safe and effective treatment method in both percutaneous and operating room procedures.

Anahtar Kelimeler

Calcium hydroxylapatite, in-office procedure, injection laryngoplasty, voice handicap index

Vokal fold paralizilerinde kalsiyum hidroksilapatit ile enjeksiyon larengoplasti sonuçları

Öz

Amaç: Bu yazıda, tek taraflı vokal fold paralizili hastalarda enjeksiyon larengoplasti deneyimlerimiz değerlendirildi.Hastalar ve Yöntemler: Ocak 2005 - Haziran 2012 tarihleri arasında kliniğimizde tek taraflı vokal fold paralizi tanısı konulan ve bu nedenle kalsiyum hidroksilapatit kullanılarak enjeksiyon larengoplasti uygulanan 68 hasta 32 erkek, 36 kadın; ort. yaş 59.5 yıl; dağılım 27-86 yıl çalışmaya dahil edildi.Bulgular: Ortalama takip süresi 36 hafta dağılım 0-340.4 hafta idi. Enjeksiyon sonrası Ses Handikap İndeksi SHİ skoru olan 29 hastanın verileri retrospektif olarak incelendi. Hastaların 16’sı %55 kadın ve ortalama hasta yaşı 60 idi dağılım 27-86 yıl . On yedi hastaya ameliyathanede süspansiyon larengoskopi, 12 hastaya klinik şartlarında perkütan enjeksiyon uygulandı. Enjeksiyon sonrası ortalama SHİ skoru 36.7 idi. Enjeksiyon öncesi ve enjeksiyon sonrası SHİ verileri olan 20 hastanın yarısına perkütan enjeksiyon larengoplasti uygulandı. Bu 20 hastanın ortalama SHİ skoru 27.9 puan artış gösterdi. Ortalama SHİ skoru perkütan grubunda 35.1 puan, süspansiyon grubunda 20.7 puan düzeldi p=0.29 . Akciğer kanseri olan bir hastanın genel sağlığı kötüleşirken enjeksiyon sonrası SHİ skoru düştü.Sonuç: Bu çalışma vokal fold paralizilerinde enjeksiyon larengoplastiyi desteklemektedir. Kalsiyum hidroksilapatit gerek perkütan gerek ameliyathane süspansiyon işlemlerinde güvenilir ve etkili bir tedavi yöntemidir

Anahtar Kelimeler

Kalsiyum hidroksilapatit, klinik şartlarında işlem, enjeksiyon larengoplasti, ses handikap indeksi

Kaynakça

• Rosen CA, Thekdi AA. Vocal fold augmentation with injectable calcium hydroxylapatite: short-term results. Journal of Voice 2004;18:387-91.
• Kwon TK, Buckmire R. Injection laryngoplasty for management of unilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg 2004;12:538-42.
• Ward PH, Hanson DG, Abemayor E. Transcutaneous teflon injection of the paralyzed vocal cord: a new technique. Laryngoscope 1985;95:644-9.
• Rosen CA, Gartner-Schmidt J, Casiano R, Anderson TD, Johnson F, Remacle M, et al. Vocal fold augmentation with calcium hydroxylapatite: twelve-month report. Laryngoscope 2009;119:1033-41.
• Nakayama M, Ford CN, Bless DM. Teflon vocal fold augmentation: failures and management in 28 cases. Otolaryngol Head Neck Surg 1993;109:493-8.
• Woo SH, Son Y, Lee SH, Park JL, Kim JP. Comparative analysis on the efficiency of the injection laryngoplasty technique using calcium hydroxyapatite (CaHA): the thyrohyoid approach versus the cricothyroid approach. Journal of Voice 2013;27:236-41.
• Chhetri DK, Jahan-Parwar B, Hart SD, Bhuta SM, Berke GS. Injection laryngoplasty with calcium hydroxylapatite gel implant in an in vivo canine model. Ann Otol Rhinol Laryngol 2004;113:259-64.
• Tanna N, Zalkind D, Glade RS, Bielamowicz SA. Foreign body reaction to calcium hydroxylapatite vocal fold augmentation. Arch Otolaryngol Head Neck Surg 2006;132:1379-82.
• Belafsky PC, Postma GN. Vocal fold augmentation with calcium hydroxylapatite. Otolaryngol Head Neck Surg 2004;131:351-4.
• Carroll TL, Rosen CA. Long-term results of calcium hydroxylapatite for vocal fold augmentation. Laryngoscope 2011;121:313-9.
• Gillespie MB, Dozier TS, Day TA, Martin-Harris B, Nguyen SA. Effectiveness of calcium hydroxylapatite paste in vocal rehabilitation. Ann Otol Rhinol Laryngol 2009;118:546-51.
• Bové MJ, Jabbour N, Krishna P, Flaherty K, Saul M, Wunar R, et al. Operating room versus office-based injection laryngoplasty: a comparative analysis of reimbursement. Laryngoscope 2007;117:226-30.
• Sulica L, Rosen CA, Postma GN, Simpson B, Amin M, Courey M, et al. Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications. Laryngoscope 2010;120:319-25.
• Lau DP, Zhang EZ, Wong SM, Lee G, Chan YH. Correlating voice handicap index and quantitative videostroboscopy following injection laryngoplasty for unilateral vocal paralysis. Otolaryngol Head Neck Surg 2010;143:190-7.