Liu Alice Q, Singer Joel, Lee Terry, Hu Amanda
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Ann Otol Rhinol Laryngol. 2020 Nov;129(11):1063-1070. doi: 10.1177/0003489420931556. Epub 2020 Jun 2.
To assess voice outcomes using the novel technique of in-office laryngeal electromyography-guided vocal fold injections (LEVFI) with hyaluronic acid to treat glottal insufficiency. Secondary objectives included determining the complication/completion rates and if any factors were associated with improved voice outcomes.
Retrospective review of patients who received their first LEVFI from August 2017 to December 2018. Three- and six-month voice outcomes were assessed. Outcomes included voice handicap index-10 (VHI-10), maximum phonation time (MPT), perceptual analysis of voice (GRBAS), fundamental frequency, and stroboscopy.
Of the 121 eligible patients (55.4% male, age 63.7 years), 94 (77.7%) had complete 3-month data and 59 (48.8%) had complete 6-month data. VHI-10 was significantly improved from 25.7 ± 7.5 to 20.9 ± 10.9 at 3 months ( < .001) and to 19.1 ± 11.5 at 6 months ( < .001). MPT improved from 6.2 ± 5.4 seconds to 9.4 ± 7.1 seconds at 3 months ( < .001) and to 11.3 ± 8.2 seconds at 6 months ( < .001). GRBAS was improved in 74.8% of patients ([65.2, 82.8] 95% CI) at 3 months and 80.8% ([69.9, 89.1]) 95% CI) at 6 months. Stroboscopy showed a glottic gap improvement in 74.8% of patients ([65.8, 82.4] 95% CI) at 3 months and in 80.3% ([65.9, 88.5] 95% CI) at 6 months. Fundamental frequency was unchanged, as expected. Multivariate analysis reported that no factors were associated with better voice outcomes. Overall, 177/181 (97.8%) injections were completed. There were no complications.
In-office LEVFI is an effective, novel technique to treat glottic insufficiency with improved voice outcomes, high completion rate, and no significant complications.
采用新型的门诊喉肌电图引导下声带注射透明质酸技术（LEVFI）评估嗓音治疗效果，以治疗声门闭合不全。次要目的包括确定并发症/完成率，以及是否有任何因素与嗓音改善效果相关。
回顾性分析2017年8月至2018年12月接受首次LEVFI治疗的患者。评估3个月和6个月时的嗓音治疗效果。评估指标包括嗓音障碍指数-10（VHI-10）、最长发声时间（MPT）、嗓音的主观分析（GRBAS）、基频和频闪喉镜检查。
121例符合条件的患者（男性占55.4%，年龄63.7岁）中，94例（77.7%）有完整的3个月数据，59例（48.8%）有完整的6个月数据。3个月时VHI-10从25.7±7.5显著改善至20.9±10.9（P<0.001），6个月时改善至19.1±11.5（P<0.001）。MPT在3个月时从6.2±5.4秒改善至9.4±7.1秒（P<0.001），6个月时改善至11.3±8.2秒（P<0.001）。3个月时74.8%的患者GRBAS得到改善（[65.2, 82.8] 95%置信区间），6个月时为80.8%（[69.9, 89.1] 95%置信区间）。频闪喉镜检查显示，3个月时74.8%的患者声门间隙改善（[65.8, 82.4] 95%置信区间），6个月时为80.3%（[65.9, 88.5] 95%置信区间）。正如预期的那样，基频没有变化。多因素分析表明，没有因素与更好的嗓音治疗效果相关。总体而言，181次注射中有177次（97.8%）完成。没有并发症发生。
门诊LEVFI是一种有效的新型技术，可用于治疗声门闭合不全，能改善嗓音效果，完成率高，且无明显并发症。
