Augmentation laryngoplasty: Results and decision plan.

Abstract

Objectives: Augmentation laryngoplasty represents a therapeutic choice for patients who suffer from glottic insufficiency of different etiologies. There have been multiple injectables that have been proven effective. The present study examines the short-term effects of vocal fold augmentation on phonation, swallowing, and breathing in individuals with glottic insufficiency. In addition, a decision plan is also proposed.

Methods: Data from medical records and operative notes were used to conduct a retrospective cohort study on patients with glottic insufficiency who underwent vocal fold augmentation from 2016 to 2023. Hyaluronic acid, calcium hydroxyapatite, and polydimethylsiloxane were the injectable materials that were used. An analysis was conducted on phonation, breathing, swallowing, and laryngoscopy findings both before and after vocal folds' augmentation.

Results: Seventy-nine patients were included, which represents 97 injections. The median (IQR) preoperative Voice Handicap Index-10 (VHI-10) score improved from 21 (15-28) to 16 (9-25) postoperatively (p < 0.001). The GRBAS scale also significantly decreased (p < 0.001). The median (IQR) preoperative Dyspnea Index score improved from 6 (0-17) to 2 (0-10) postoperatively (p < 0.05). Laryngoscopic findings showed significant improvement in the bulk of the vocal folds. There was no significant change in swallowing.

Conclusions: In case of dysphonia secondary to glottic insufficiency, augmentation laryngoplasty using various injectable materials has proven to be an effective option across a range of different etiologies, as it results in significant improvements in voice quality. The choice of the injectable material depends upon the severity and the etiology of glottic insufficiency.