Suzuki Hirotaka, Makiyama Kiyoshi, Hirai Ryoji, Matsuzaki Hiroumi, Furusaka Toru, Oshima Takeshi
Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan..
Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan.
J Voice. 2016 Nov;30(6):761.e11-761.e17. doi: 10.1016/j.jvoice.2015.09.018. Epub 2015 Nov 6.
Basic fibroblast growth factor promotes wound healing by accelerating healthy granulation and epithelialization. However, the duration of the effects of a single intracordal injection of basic fibroblast growth factor has not been established, and administration intervals and timing have yet to be standardized. Here, we administered a single injection to patients with insufficient glottic closure and conducted follow-up examinations with high-speed digital imaging to determine the duration of the treatment response.
Case series.
For treatment, 20 µg/mL recombinant human basic fibroblast growth factor was injected into two vocal cords. The following examinations were performed before the procedure and at 3-month intervals for 12 months starting at 1 month postinjection: Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale assessment, maximum phonation time, acoustic analysis, high-speed digital imaging, glottal wave analysis, and kymographic analysis.
Postinjection, the GRBAS scale score decreased, and the maximum phonation time was prolonged. In addition, the mean minimum glottal area and mean minimum glottal distance decreased. These changes were significant at 12 months postinjection compared with preinjection. However, there were no significant changes in the vibrations of the vocal cord margins.
The intracordal injection of basic fibroblast growth factor improved insufficient glottic closure without reducing the vibrations of the vocal cord margins. This effect remained evident at 12 months postinjection. A single injection can be expected to yield a sufficient and persistent long-term effect.
碱性成纤维细胞生长因子通过加速健康肉芽组织形成和上皮化来促进伤口愈合。然而，单次声带内注射碱性成纤维细胞生长因子的作用持续时间尚未确定，给药间隔和时间也有待标准化。在此，我们对声门闭合不全的患者进行单次注射，并通过高速数字成像进行随访检查，以确定治疗反应的持续时间。
病例系列。
治疗时，将20μg/mL重组人碱性成纤维细胞生长因子注射到两条声带中。在注射前以及注射后1个月开始，每隔3个月进行12个月的以下检查：分级、粗糙度、气息声、无力和紧张（GRBAS）量表评估、最长发声时间、声学分析、高速数字成像、声门波分析和记波图分析。
注射后，GRBAS量表评分降低，最长发声时间延长。此外，平均最小声门面积和平均最小声门距离减小。与注射前相比，这些变化在注射后12个月时具有显著性。然而，声带边缘的振动没有显著变化。
声带内注射碱性成纤维细胞生长因子改善了声门闭合不全，而没有降低声带边缘的振动。这种效果在注射后12个月时仍然明显。单次注射有望产生充分且持久的长期效果。
