Early Transthyrohyoid Injection Laryngoplasty Under Local Anaesthesia in a Single Tertiary Center of Southeast Asia: Multidimensional Voice Outcomes.

OBJECTIVE

To study the effectiveness of early percutaneous transthyrohyoid injection laryngoplasty under local anesthesia in improving voice quality in unilateral vocal fold paralysis (UVFP) patients.

METHODS

Longitudinal data of 29 UVFP patients who underwent injection laryngoplasty within six months from the onset of the symptoms were studied. The injectate (0.5-1 mL) was hyaluronic acid-based material (Juvéderm ULTRA XC; Allergan Industrie, France) that was delivered under local anesthesia with transthyrohyoid approach using a double-bend 21G needle. Multidimensional voice outcomes employing: 1) Malay-Voice-Handicap Index-10 (mVHI-10); 2) maximum phonation time (MPT); and 3) acoustic analysis [jitter%, shimmer% and noise-harmonic ratio (NHR)] were used to assess the treatment progress. The voice parameters were measured at baseline (2 weeks pre-injection), and at the first and third months post-injection.

RESULTS

The mean age of the 29 patients was 44.69 years, with a female-to-male ratio of 3.14:1. The voice outcomes measured at different time points were evaluated with repeated measures ANOVA. Significant improvement was observed from baseline to three months post injection laryngoplasty for mVHI-10, jitter, and NHR (p<0.001), shimmer (p=0.005) and MPT (p=0.018). Following the procedure, none of the patients developed any major complications.

CONCLUSION

Office setting early transthyrohyoid injection laryngoplasty using a double-bend needle is a safe and effective procedure in patients with UVFP with evidence of significant improvement in voice and life quality.