Vinson KN¹, Zraick RI, Ragland FJ.
Abstract
OBJECTIVES/HYPOTHESIS: To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the long-term treatment of unilateral vocal fold paralysis (UVFP).
STUDY DESIGN: A retrospective study of patients with UFVP who underwent either injection or medialization laryngoplasty at the University of Arkansas for Medical Sciences between July 29, 2003 and November 18, 2005.
METHODS: The data analyzed included patient characteristics and type of intervention, along with the pretreatment and post-treatment parameters of videostrobolaryngoscopy, perceptual voice analysis, and patients’ subjective assessment of voice handicaр.
RESULTS: Thirty-four patients were evaluated, 15 new and 19 from a previous study. The average time from intervention to post-treatment evaluation in the new cohort was 4.8 months (range, 1.5-10.5 months). The average time from intervention to post-treatment in the combined cohort was 6.4 months (range, 1-24 months). Improvements were demonstrated in each of the measured voice parameters in both the injection and the medialization groups, and no significant differences were found in the degree of improvement between the two groups. Limited data on aerodynamic and acoustic voice measurements showed a trend toward improvement in each treatment group.
CONCLUSIONS: Injection and medialization laryngoplasty were comparable in achieving voice improvement at the average long-term follow-up of 6 months.
Endoscopic medialization with Vox implant: our experience
Turner F1, Duflo S. Michel J. Giovanni A.
Abstract
OBJECTIVE: The purpose of this work is to analyze our preliminary results on the endoscopic vocal cords medialization by Bioplastique.
MATERIAL AND METHOD: This was a retrospective study on 39 cases of unilateral laryngeal paralysis, treated with the injection of Vox-implant between May 2004 and August 2006. The evolution of the swallowing disorders was followed by video fluoroscopy. The phoniatric evaluation was based on an auto evaluation questionnaire: Voice Handicap Index 10 (VHI-10).
RESULTS: Of the 19 patients who presented with swallowing disorder, 18 gave a normal video fluoroscopy test. In only one case, a second injection, one year later was necessary to completely cure the patient from fluid aspirations. Thirty two patients were satisfied with the post-operative vocal results. The Wilcoxon matched pairs test gave a statistically significant difference between pre and post-operative VHI-10 (p< 0,001). The voice handicap improved approximately 53%.
CONCLUSION: Bioplastic Vox-Implant profits from a simple injection technique, it is well tolerated and gives a good voice quality. It allows moreover a fast and simple resolution of the problem, can be repeated, and in case of failure or insufficiency a thyroplasty remains possible.