• Title/Summary/Keyword: Injection laryngoplasty

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The Effect of $Artecoll^{(R)}$ Injection Laryngoplasty for Patients with Vocal Atrophy and Mild Sulcus Vocalis (성대위축증 및 경미한 성대구증에서 $Artecoll^{(R)}$을 이용한 후두주입성형술의 효과)

  • Yun, Young-Sun;Yeo, Jinha;Choi, Ji Eun;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.24 no.2
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    • pp.112-117
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    • 2013
  • Background and Objectives : This study aimed to determine the clinical effect of $Artecoll^{(R)}$ injection laryngoplasty for patients with vocal atrophy and mild sulcus vocalis. Materials and Method : Forty-one patients with vocal atrophy and/or mild sulcus vocalis received transcutaneous $Artecoll^{(R)}$ injection into the vocal folds under local anesthesia. Subjective evaluations including voice handicap index (VHI) and perceptual grading with Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scales and objective evaluations including jitter, shimmer, noise-to-harmonic ratio (NHR), speaking fundamental frequency (SFF) and maximum phonation time (MPT) were evaluated before and 3 months after the injection. Results : VHI and Grade, Breathiness and Strain scales in GRBAS showed significant improvement 3 months after injection. SFF and MPT also significantly improved after the injection ; MPT increased and SFF in male patients decreased. Conclusion : Injection laryngoplasty with $Artecoll^{(R)}$ is an effective method for correcting the glottal insufficiency and improving voice quality in patients with vocal atrophy and/or mild sulcus.

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Technical Review of How to Determine the Exact Location of Needle Tip During Office-Based Injection Augmentation of the Vocal Folds Via Cricothyroid Approach (외래에서 시행하는 경윤상갑상막 접근 성대주입술 중 주입 위치를 정확하게 파악하는 방법에 관한 기술적 고찰)

  • Park, Sung Joon;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.70-75
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    • 2018
  • The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.

Preliminary Reports of Injection Laryngoplasty with Plasma Gel (Plasma Gel을 이용한 성대 주입술의 예비적 보고)

  • Ahn, Seong-Yong;Lee, Hong-Kyoung;Kim, Jin-Pyeong;Park, Jeong-Je;Joo, Yeon-Hee;Lee, Eun-Jae;Woo, Seung-Hoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.32-36
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    • 2010
  • Background : Vocal fold injection using autologous material (fat or collagen) is very useful. However, Autologous material have variable resorption times and results, Plasma gel is a new injection material. The purpose of this study is to introduce a new injection material and discuss the effectiveness and complications. Subjects and Method: Eleven cases with vocal cord paralysis were analyzed after plasma gel injection, The plasma gel was acquired from patient's own blood. The preoperative and postoperative parameters including maximum phonation time (MPT) and subject aspiration score were analyzed. Results: There was a significant improvement in MPT and aspiration score in the case of vocal cord palsy. There was only one laryngeal complication. Conclusion : According to these preliminary results, the injection laryngoplasty with Plasma gel is a simple, safe, cheap procedure for temporally vocal fold palsy.

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Comparison of the Voice Outcome After Injection Laryngoplasty: Unilateral Vocal Fold Paralysis Due to Cancer Nerve Invasion and Iatrogenic Injury (성대주입술 후 음향학적 분석결과 비교: 암의 신경 침윤으로 인한 일측성 성대마비 환자와 수술 후 발생한 일측성 성대마비 환자)

  • Yongmin, Cho;Hyunseok, Choi;Kyoung Ho, Oh;Seung-Kuk, Baek;Jeong-Soo, Woo;Soon Young, Kwon;Kwang-Yoon, Jung;Jae-Gu, Cho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.3
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    • pp.172-178
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    • 2022
  • Background and Objectives Injection laryngoplasty is a common method for treatment of unilateral vocal fold paralysis. Unilateral vocal fold paralysis has various causes, including idiopathic, infection, stroke, neurologic condition, surgery and nerve invasion by cancer. To the knowledge of the authors, there was no study on the relationship between the causes of vocal cord paralysis and the outcome of injection laryngoplasty. Therefore, we tried to investigate the difference in the outcomes of injection laryngoplasty between vocal cord paralysis after surgery group and nerve invasion by cancer group. Materials and Method A retrospective analysis was performed for 24 patients who underwent vocal cord injection due to unilateral vocal cord paralysis caused by surgery or nerve invasion by cancer. The objective quality of the voice was assessed by acoustic voice analysis with the Multi-Dimensional Voice Program. Results Both group showed an improvement of fundamental frequemcy (F0), jitter percent, shimmer (percent), and noise to hearmonic ratio (NHR) after injection laryngoplasty. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of F0, shimmer percent and NHR than the vocal cord paralysis due to surgery group, but there was not statistically significant. Conclusion Our study did not show a statistically significant difference in outcome between vocal cord paralysis due to cancer invasion group and surgery group, but statistically tendency was suggested. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of acoustic voice analysis than surgery group.

Principles and Complications of Laryngeal Framework Surgery (후두골격수술의 원칙 및 합병증)

  • Moon, Jeong-Hwan;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.18-22
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    • 2011
  • Laryngeal framework surgery comprises medialization laryngoplasty and arytenoid adduction. Since their introduction in the 1970s, these procedures have become standard treatments for vocal fold paralysis and glottal incompetence. However, frequency of laryngeal framework surgery is conjectured to relatively decrease along with the introduction of injection laryngoplasty. In this manuscript, indications for laryngeal framework surgery were highlighted in contrast to those of injection laryngoplasty. The authors introduced the basic concepts and principles as well as surgical techniques of laryngeal framework surgery. Even though the incidence of major and/or minor complications after laryngeal framework surgery is not high, surgeons should be well aware of its possible complications and they should be familiar with tips and know-how to avoid or cope with complications.

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Benefits of Palliative Office-Based Hyaluronic Acid Injection Laryngoplasty in Cancer-Related Unilateral Vocal Cord Paralysis Patients (악성 종양 관련 일측성 성대 마비 환자에서 고식적 Hyaluronic Acid 성대 주입 성형술의 유용성)

  • Kim, Go-Woon;Park, Young-Hak;Joo, Young-Hoon;Kim, Sang-Yeon;Shim, Mi-Ran;Hwang, Yeon-Sin;Sun, Dong-Il
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.30-36
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    • 2018
  • Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

Efficacy of Calcium Hydroxyapatite in Vocal Fold Augmentation for Unilateral Vocal Fold Paralysis in Asian

  • Lee, Doh Young;Chung, Eun-Jae;Kwon, Seong-Keun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.83-86
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    • 2018
  • Background and Objectives : This study aimed to evaluate efficacy and complication of injection laryngoplasty using calcium hydroxyapatite (CaHA) for unilateral vocal fold paralysis in Asian. Materials and Methods : A prospective study was conducted on the adult patients with unilateral vocal fold paralysis from May 2015 through January 2016. Injection laryngoplasty was performed by one laryngologist. All patients underwent prospective voice evaluation using the subjective and objective comprehensive battery of assessments, before the procedure and after the procedure at 3 months, and 6 months. Results : A total of 7 patients (5 males and 2 females) were included in this study. VHI-10 was significantly decreased after injection laryngoplasty, at postoperative 6 months (p=0.031), while VAS score and MDADI showed no difference. GRBAS scale gradually decreased in 3 months and 6 months follow-up without statistical significance. Acoustic analysis revealed that jitter, shimmer, and noise-to-harmonic ratio continuously decreased from the baseline at 3 months and 6 months, although statistical significance was not attained. In the aerodynamic analysis, maximal phonation time was gradually increased at 3months and 6 months with significant difference (p=0.016, 0.031, respectively). There was no side effect associated with the procedure. Conclusion : CaHA can be safely used in Asian patients and the onset of maximal efficacy seems to be slow than other studies with Caucasian patients.