Department of ENT, Head and Neck Surgery H5-Q, Leiden University Medical Center, Albinusdreef 2, Postbus 9600, 2300 RC, Leiden, The Netherlands.
Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
Eur Arch Otorhinolaryngol. 2022 Apr;279(4):1967-1978. doi: 10.1007/s00405-021-07193-7. Epub 2021 Nov 30.
The purpose of this study was to evaluate short- and long-term outcome of injection augmentation with autologous adipose tissue (AAT) and calcium hydroxylapatite injection (CAHA) in patients with a unilateral vocal fold paralysis (UVFP).
DESIGN/METHODS: A retrospective cohort study was performed in patients diagnosed with UVFP, who had received injection augmentation with AAT or CAHA. Multidimensional voice analysis was performed before, 3 and 12 months after injection. This analysis included patient self-assessment (Voice Handicap Index-30), perceptual (overall dysphonia grade according to the GRBAS scale), aerodynamic (MPT, s/z ratio) and acoustic (fundamental frequency, dynamic range) parameters. Effects were assessed using a linear mixed model analysis.
Forty-six patients were available for evaluation, with a total of 53 injection augmentations (AAT n = 39; CAHA n = 14). We found significant improvement of patient self-assessment and perceptive voice outcome at 3 months, which were maintained at 12 months. In the CAHA group, s/z ratio and dynamic range of extreme frequencies also improved significantly over time. No statistically significant differences were found between the two treatments (AAT vs. CAHA). No major complications were reported.
This study, using a guide-line recommended panel of outcome parameters, shows a high success rate of injection augmentation with AAT or CAHA for patients with UVFP at 12 months with significant improvement in most voice outcome parameters, although voices do not completely normalize. There is no significant difference in outcome between the two materials.
本研究旨在评估自体脂肪组织（AAT）和羟基磷灰石钙（CAHA）注射治疗单侧声带麻痹（UVFP）患者的短期和长期疗效。
对诊断为单侧声带麻痹并接受 AAT 或 CAHA 注射增强治疗的患者进行回顾性队列研究。在注射前、注射后 3 个月和 12 个月进行多维嗓音分析。该分析包括患者自我评估（嗓音障碍指数-30）、知觉（GRBAS 量表的整体嗓音障碍等级）、空气动力学（最长发声时间、s/z 比）和声学（基频、动态范围）参数。采用线性混合模型分析评估效果。
46 例患者可进行评估，共进行了 53 次注射增强（AAT n=39；CAHA n=14）。我们发现患者自我评估和知觉嗓音结果在 3 个月时显著改善，并在 12 个月时保持稳定。在 CAHA 组，s/z 比和极低频的动态范围也随时间显著改善。两种治疗方法（AAT 与 CAHA）之间无统计学差异。未报告重大并发症。
本研究使用指南推荐的一系列疗效参数，表明 AAT 或 CAHA 注射增强治疗单侧声带麻痹患者在 12 个月时成功率高，大多数嗓音疗效参数显著改善，尽管嗓音无法完全正常化。两种材料的疗效无显著差异。
