Office-Based Intracordal Hyaluronate Injections Improve Quality of Life in Thoracic-Surgery-Related Unilateral Vocal Fold Paralysis

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2015 Oct 9

PMID 26448034

Citations 11

Authors

Tuan-Jen Fang

Li-Jen Hsin

Hsiu-Feng Chung

Hui-Chen Chiang

Hsueh-Yu Li

Alice M K Wong

Yu-Chen Pei

Affiliations

Soon will be listed here.

Abstract

Thoracic-surgery-related unilateral vocal fold paralysis (UVFP) may cause severe morbidity and can cause profound functional impairment and psychosocial stress in patients with pre-existing thoracic diseases. In-office intracordal hyaluronate (HA) injections have recently been applied to improve voice and quality of life in patients with vocal incompetence, but their effect on thoracic-surgery-related UVFP remains inconclusive. We therefore conducted a prospective study to clarify the effect of early HA injection on voice and quality of life in patients with thoracic-surgery-related UVFP. Patients with UVFP within 3 months after thoracic surgery who received office-based HA injection were recruited. Quantitative laryngeal electromyography, videolaryngostroboscopy, voice-related life quality (voice outcome survey), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1 month postinjection. A total of 104 consecutive patients accepted office-based HA intracordal injection during the study period, 34 of whom were treated in relation to thoracic surgery and were eligible for inclusion. Voice-related life quality, voice laboratory analysis, and most generic quality of life domains were significantly improved at 1 month after in-office HA intracordal injection. No HA-related complications were reported. Single office-based HA intracordal injection is a safe and effective treatment for thoracic-surgery-related UVFP, resulting in immediate improvements in patient quality of life, voice quality, and swallowing ability.

Citing Articles

Multicentre randomized clinical trial on robot-assisted versus video-assisted thoracoscopic oesophagectomy (REVATE trial).

Chao Y, Li Z, Jiang H, Wen Y, Chiu C, Li B Br J Surg. 2024; 111(7).

PMID: 38960881 PMC: 11221944. DOI: 10.1093/bjs/znae143.

Temporal Trends in Survival Outcomes for Patients with Esophageal Cancer Following Neoadjuvant Chemoradiotherapy: A 14-Year Analysis.

Ng C, Chiu C, Yeh C, Chang Y, Hou M, Tseng C Ann Surg Oncol. 2024; 31(10):6652-6661.

PMID: 38926213 DOI: 10.1245/s10434-024-15644-8.

Prognostic Factors for Recovery from Left Recurrent Laryngeal Nerve Palsy After Minimally Invasive McKeown Esophagectomy: A Retrospective Study.

Kuo C, Chiu C, Fang T, Chao Y Ann Surg Oncol. 2023; 31(3):1546-1552.

PMID: 37989958 DOI: 10.1245/s10434-023-14560-7.

Clinical and functional characteristics of lung surgery-related vocal fold palsy.

Chang T, Fang T, Wong A, Wu C, Pei Y Biomed J. 2022; 44(6 Suppl 1):S101-S109.

PMID: 35735079 PMC: 9039099. DOI: 10.1016/j.bj.2020.07.005.

Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?.

Lee Y, Pei Y, Lu Y, Chung H, Li H, Lee L Biomolecules. 2021; 11(11).

PMID: 34827578 PMC: 8615747. DOI: 10.3390/biom11111580.

References

Wright C, Zeitels S . Recurrent laryngeal nerve injuries after esophagectomy. Thorac Surg Clin. 2006; 16(1):23-33, v. DOI: 10.1016/j.thorsurg.2006.01.006. View

Grant J, Hartemink D, Patel N, Merati A . Acute and subacute awake injection laryngoplasty for thoracic surgery patients. J Voice. 2006; 22(2):245-50. DOI: 10.1016/j.jvoice.2006.09.001. View

Dimarakis I, Protopapas A . Vocal cord palsy as a complication of adult cardiac surgery: surgical correlations and analysis. Eur J Cardiothorac Surg. 2004; 26(4):773-5. DOI: 10.1016/j.ejcts.2004.06.003. View

Pei Y, Fang T, Hsin L, Li H, Wong A . Early hyaluronate injection improves quality of life but not neural recovery in unilateral vocal fold paralysis: an open-label randomized controlled study. Restor Neurol Neurosci. 2015; 33(2):121-30. DOI: 10.3233/RNN-140439. View

Fang T, Li H, Gliklich R, Chen Y, Wang P . Assessment of Chinese-version voice outcome survey in patients with unilateral vocal cord paralysis. Otolaryngol Head Neck Surg. 2007; 136(5):752-756. DOI: 10.1016/j.otohns.2006.11.048. View

Ko H, Lee L, Li H, Fang T . Etiologic features in patients with unilateral vocal fold paralysis in Taiwan. Chang Gung Med J. 2009; 32(3):290-6. View

Pei Y, Fang T, Li H, Wong A . Cricothyroid muscle dysfunction impairs vocal fold vibration in unilateral vocal fold paralysis. Laryngoscope. 2013; 124(1):201-6. DOI: 10.1002/lary.24229. View

Friedman A, Burns J, Heaton J, Zeitels S . Early versus late injection medialization for unilateral vocal cord paralysis. Laryngoscope. 2010; 120(10):2042-6. DOI: 10.1002/lary.21097. View

Graboyes E, Bradley J, Meyers B, Nussenbaum B . Efficacy and safety of acute injection laryngoplasty for vocal cord paralysis following thoracic surgery. Laryngoscope. 2011; 121(11):2406-10. DOI: 10.1002/lary.22178. View

10.

Lodewyks C, White C, Bay G, Hiebert B, Wu B, Barker M . Vocal Cord Paralysis After Thoracic Aortic Surgery: Incidence and Impact on Clinical Outcomes. Ann Thorac Surg. 2015; 100(1):54-8. DOI: 10.1016/j.athoracsur.2015.02.021. View

11.

Gliklich R, Glovsky R, Montgomery W . Validation of a voice outcome survey for unilateral vocal cord paralysis. Otolaryngol Head Neck Surg. 1999; 120(2):153-8. DOI: 10.1016/S0194-5998(99)70399-2. View

12.

Lau D, Lee G, Wong S, Lim V, Chan Y, Tan N . Injection laryngoplasty with hyaluronic acid for unilateral vocal cord paralysis. Randomized controlled trial comparing two different particle sizes. J Voice. 2009; 24(1):113-8. DOI: 10.1016/j.jvoice.2008.05.007. View

13.

Prendes B, Yung K, Likhterov I, Schneider S, Al-Jurf S, Courey M . Long-term effects of injection laryngoplasty with a temporary agent on voice quality and vocal fold position. Laryngoscope. 2012; 122(10):2227-33. DOI: 10.1002/lary.23473. View

14.

Omori K, Kacker A, Slavit D, BLAUGRUND S . Quantitative videostroboscopic measurement of glottal gap and vocal function: an analysis of thyroplasty type I. Ann Otol Rhinol Laryngol. 1996; 105(4):280-5. DOI: 10.1177/000348949610500407. View

15.

Fang T, Pei Y, Li H, Wong A, Chiang H . Glottal gap as an early predictor for permanent laryngoplasty in unilateral vocal fold paralysis. Laryngoscope. 2014; 124(9):2125-30. DOI: 10.1002/lary.24689. View

16.

Pertl L, Zacherl J, Mancusi G, Gachter J, Asari R, Schoppmann S . High risk of unilateral recurrent laryngeal nerve paralysis after esophagectomy using cervical anastomosis. Eur Arch Otorhinolaryngol. 2011; 268(11):1605-10. DOI: 10.1007/s00405-011-1679-7. View

17.

Song P, Sung C, Franco Jr R . Voice outcomes after endoscopic injection laryngoplasty with hyaluronic acid stabilized gel. Laryngoscope. 2011; 120 Suppl 4:S199. DOI: 10.1002/lary.21666. View

18.

Pham V, Connelly D, Wei J, Sykes K, OBrien J . Vocal cord paralysis and Dysphagia after aortic arch reconstruction and Norwood procedure. Otolaryngol Head Neck Surg. 2014; 150(5):827-33. PMC: 4262533. DOI: 10.1177/0194599814522413. View