Department of Otolaryngology Head and Neck Surgery, Mount Sinai Medical Center, New York, New York.
Department of Otolaryngology-Head and Neck Surgery, Loma Linda Health University, Loma Linda, California; Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
J Voice. 2023 Jul;37(4):621-628. doi: 10.1016/j.jvoice.2021.02.022. Epub 2021 Mar 18.
Improving the voice of patients with vocal atrophy, scar, and sulcus vocalis remains challenging. Platelet-rich plasma (PRP) is an autologous biological suitable for regenerative medicine. Office-based injections of PRP may serve as a source of improved wound healing.
Thirty two office based injections of PRP were performed in 14 patients with scar, sulcus, and vocal atrophy (12 scars, 1 sulcus, and 1 atrophy). PRP was prepared using 20 cc blood draw and double centrifugation method. Injection laryngoplasty was performed using trans cervical or indirect trans oral technique (10 trans cervical, 22 trans-oral). Volume of PRP use was 0.5-0.7 cc per side. Injections varied from 1 to 3 injections at monthly intervals. Videostroboscopy, Voice Handicap Index (VHI-10), and an objective analysis of the voice using Cepstral Peak Prominence (Cepstral Spectral Index of Dysphonia) were recorded. An expert rater speech pathologist rated the audio and stroboscopy results.
Median follow-up was 15 months. No patients were made worse. The mean VHI-10 before the injection was 23. VHI-10 after the injection was 12.5 (P < 0.01). The mean Cepstral Spectral Index of Dysphonia score for CAPE-V sentence was 42.5 before the injection and 23.5 (P < 0.01) after the injection. The expert rater thought the post treatment was better (9/14 acoustic, 10/14 stroboscopy). Eleven of the 14 patients thought the intervention was worthwhile to repeat. The other 3 patients thought the improvement was transient.
Office PRP injection into the vocal fold of patients with scar, sulcus, and atrophy may result in short term voice improvements. It is a biological worth considering.
改善声带萎缩、瘢痕和声带沟患者的嗓音仍然具有挑战性。富含血小板的血浆（PRP）是一种适合再生医学的自体生物制剂。基于办公室的 PRP 注射可能成为改善伤口愈合的一种来源。
14 名瘢痕、声带沟和声带萎缩患者（12 名瘢痕患者、1 名声带沟患者和 1 名声带萎缩患者）共接受了 32 次基于办公室的 PRP 注射。PRP 采用 20cc 采血和双离心法制备。经颈或间接经口技术行注射性喉成形术（10 次经颈，22 次经口）。每侧使用的 PRP 量为 0.5-0.7cc。每月间隔注射 1 至 3 次。记录频闪喉镜、嗓音障碍指数（VHI-10）和使用频谱峰突出度（嗓音障碍的频谱指数）对嗓音进行的客观分析。一位专家语言病理学家对音频和频闪喉镜结果进行评分。
中位随访时间为 15 个月。无患者病情恶化。注射前的平均 VHI-10 为 23，注射后的 VHI-10 为 12.5（P<0.01）。CAPE-V 句的平均频谱峰突出度值在注射前为 42.5，注射后为 23.5（P<0.01）。9/14 名专家认为治疗后的声学效果更好，10/14 名专家认为频闪喉镜效果更好。14 名患者中有 11 名认为干预措施值得重复，另外 3 名患者认为改善是暂时的。
基于办公室的 PRP 注射到瘢痕、声带沟和萎缩的声带患者中可能会导致短期的嗓音改善。这是一种值得考虑的生物制剂。
