Itziar Gotxi-Erezuma1, Mónica Ortega-Galán2, Ainhoa Laso-Elguezabal3, Gonzalo Prieto Puga3, Carolina Bullido-Alonso3, Susana García-Gutiérrez4, Ane Anton-Ladislao5, Enrique Moreno-Alonso3. 1. Servicio de Otorrinolaringología, Hospital Galdakao-Usansolo, Vizcaya, España. Electronic address: i.gotxierezuma@gmail.com. 2. Servicio de Neurofisiología Clínica, Hospital Galdakao-Usansolo, Vizcaya, España. 3. Servicio de Otorrinolaringología, Hospital Galdakao-Usansolo, Vizcaya, España. 4. Unidad de Investigación, Hospital Galdakao-Usansolo, Vizcaya, España; REDISSEC- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, España. 5. Unidad de Investigación, Hospital Galdakao-Usansolo, Vizcaya, España.
Abstract
INTRODUCTION AND OBJECTIVE: To assess the effectiveness of electromyography-guided hyaluronic acid injection laryngoplasty in the early stage of unilateral vocal fold paralysis in terms of patient recovery from dysphonia and quality of life. METHODS: Between January and December 2014, 28 patients with unilateral vocal fold paralysis underwent electromyography and injection of hyaluronic acid in the thyroarytenoid muscle. We compared the voice handicap index, grade, roughness, breathiness, asthenia, strain scale (GRBAS), videostroboscopic parameters and maximum phonation time assessed before, 15 days and 6 months after the intervention, using the non-parametric Wilcoxon rank test. RESULTS: Out of the 28 patients, 1 had a haematoma in the injected vocal fold (3.57%) and 6 required second injections. The maximum phonation time of the vowel /e/ increased from 6.07 to 12.14 sec. (15 days post-intervention) and subsequently 12.75 (6 months post-intervention). There was also a significant improvement in the grade, roughness, breathiness, asthenia, strain scale in parameters G, B and A both 15 days and 6 months after the intervention. The voice handicap index score decreased from 58.29 to 37.63 (15 days post-intervention) and 29.64 (6 months post-intervention). CONCLUSIONS: Electromyography-guided hyaluronic injection laryngoplasty in unilateral vocal fold paralysis enables, in the same intervention, neuromuscular assessment and temporary treatment of glottic insufficiency with a low risk of complications and improvement in patient's quality of life. This may reduce the need for subsequent treatments, but further research is required to confirm these findings.
INTRODUCTION AND OBJECTIVE: To assess the effectiveness of electromyography-guided hyaluronic acid injection laryngoplasty in the early stage of unilateral vocal fold paralysis in terms of patient recovery from dysphonia and quality of life. METHODS: Between January and December 2014, 28 patients with unilateral vocal fold paralysis underwent electromyography and injection of hyaluronic acid in the thyroarytenoid muscle. We compared the voice handicap index, grade, roughness, breathiness, asthenia, strain scale (GRBAS), videostroboscopic parameters and maximum phonation time assessed before, 15 days and 6 months after the intervention, using the non-parametric Wilcoxon rank test. RESULTS: Out of the 28 patients, 1 had a haematoma in the injected vocal fold (3.57%) and 6 required second injections. The maximum phonation time of the vowel /e/ increased from 6.07 to 12.14 sec. (15 days post-intervention) and subsequently 12.75 (6 months post-intervention). There was also a significant improvement in the grade, roughness, breathiness, asthenia, strain scale in parameters G, B and A both 15 days and 6 months after the intervention. The voice handicap index score decreased from 58.29 to 37.63 (15 days post-intervention) and 29.64 (6 months post-intervention). CONCLUSIONS: Electromyography-guided hyaluronic injection laryngoplasty in unilateral vocal fold paralysis enables, in the same intervention, neuromuscular assessment and temporary treatment of glottic insufficiency with a low risk of complications and improvement in patient's quality of life. This may reduce the need for subsequent treatments, but further research is required to confirm these findings.
Authors: F Granato; F Martelli; L V Comini; P Luparello; S Coscarelli; O Le Seac; S Carucci; P Graziani; R Santoro; G Alderotti; M R Barillari; Giuditta Mannelli Journal: Eur Arch Otorhinolaryngol Date: 2019-08-02 Impact factor: 2.503