Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
Auris Nasus Larynx. 2021 Oct;48(5):949-955. doi: 10.1016/j.anl.2021.02.004. Epub 2021 Feb 24.
Fibrotic changes in the vocal fold mucosa have been observed in patients with vocal fold scarring, aged vocal fold, and sulcus vocalis, which often lead to severe voice disorders. Previous research suggests that the basic fibroblast growth factor (b FGF) improves variations in vocal fold properties [1,2]. Although clinical studies on b FGF treatments have been conducted [3,4,5], these studies only demonstrated the efficacy of this drug over a short period. The present study is the first to investigate the long-term efficacy of b FGF treatment.
b FGF injections were performed in six patients from January of 2016 to December of 2017 at our institution. Patient follow-up continued for at least two years after the last injection. Three patients had vocal fold scarring, two had aged vocal fold atrophy, and one patient had sulcus vocalis. Each vocal fold was injected with 10 µg of b FGF four times. Voice and stroboscopic examinations were performed after surgery (at one month, three months, six months, one year, two years). Fundamental frequency, maximum phonation time (MPT), mean flow rate (MFR), amplitude perturbation quotient (APQ), pitch perturbation quotient (PPQ), and noise-to-harmonic ratio (NHR), and voice handicap index-10 (VHI-10) were examined and compared statistically between the pretreatment time and at each posttreatment time point.
The speaking F0 had an obvious decreasing tendency, with significant differences suggesting the increase in volume in the vocal folds. Aerodynamic parameters also showed small improvements. The most remarkable improvement was observed in the acoustic parameters, indicating that the treatment could improve the vocal fold to make vibrations symmetrically and regularly for a long period. Achievement of symmetry and regularity on vocal fold vibrations suggested the property changes had happened in the vocal folds. Consequently, the score of VHI-10 had improved, indicating high patient satisfaction with this treatment.
b FGF injections could be a reliable treatment option for diseases that deteriorate the property of vocal fold.
在声带瘢痕、老年声带和声带沟患者中观察到声带黏膜的纤维化改变，这通常导致严重的声音障碍。先前的研究表明，碱性成纤维细胞生长因子（bFGF）可改善声带特性的变化[1,2]。尽管已经进行了 bFGF 治疗的临床研究[3,4,5]，但这些研究仅在短时间内证明了该药物的疗效。本研究首次探讨了 bFGF 治疗的长期疗效。
我们机构于 2016 年 1 月至 2017 年 12 月对 6 名患者进行了 bFGF 注射。最后一次注射后，患者至少随访两年。3 名患者患有声带瘢痕，2 名患者患有老年声带萎缩，1 名患者患有声带沟。每侧声带注射 10µg bFGF 四次。手术后（一个月、三个月、六个月、一年、两年）进行嗓音和频闪喉镜检查。对基频、最长发声时间（MPT）、平均气流率（MFR）、振幅微扰比（APQ）、频率微扰比（PPQ）、噪声与谐噪比（NHR）和嗓音障碍指数-10（VHI-10）进行检测，并在术前和每个术后时间点进行统计学比较。
说话时的基频呈明显下降趋势，体积增加差异有统计学意义。气动参数也显示出较小的改善。声学参数的改善最为显著，表明治疗可以使声带长期对称、规律地振动。声带振动的对称性和规律性的实现表明声带的特性发生了变化。因此，VHI-10 的评分有所提高，表明患者对这种治疗非常满意。
bFGF 注射可能是一种可靠的治疗选择，可用于改善声带疾病的特性。
