Office-based Injection Laryngoplasty: Outcome after Hydroxylapatite Injection

Abstract

Ab s t r Ac t Background: Office-based injection laryngoplasty is a surgical procedure that becomes more popular for vocal fold (VF) augmentation. Hydroxylapatite (Radiesse) is used to narrow the glottal gap in cases with glottal insufficiency. Objective: To assess voice outcome and patient’s quality of life in selected group of dysphonic patients using office-based hydroxylapatite injection under local anesthesia in cases with glottal insufficiency. Materials and methods: Forty-one patients with different voice disorders, namely sulcus vocalis, unilateral VF immobility, and VF atrophy were selected. All patients underwent office-based injection of hydroxylapatite under local anesthesia. All patients were evaluated by using auditory perceptual analysis, laryngeal videostroboscope (LVS), acoustic analysis, and voice handicap index (VHI) preoperatively and 3 months postoperatively. Results: Improvement in glottal gap in all groups of patients was measured by LVS examination. Also, there was significant improvement in acoustic correlates of dysphonia, namely jitter%, shimmer%, noise to harmonic ratio (NHR), and maximum phonation time (MPT) in patients with unilateral VF immobility and VF atrophy. Also improved quality postinjection was reported in all groups measured by VHI. Conclusion: Office-based injection laryngoplasty with hydroxylapatite is a reliable and effective procedure in management of mild and moderate glottal gap because of unilateral VF immobility and VF atrophy.