Yamauchi Tomohiko, Kanazawa Takeharu, Hasegawa Tomohiro, Kurakami Kazuya, Konomi Ujimoto, Hirosaki Mayu, Komazawa Daigo, Nozawa Miki, Takahashi Satoka, Watanabe Yusuke
Division of Laryngeal Surgery, Department of Otolaryngology-Head and Neck Surgery Jichi Medical University Shimotsuke Japan.
Tokyo Voice Center International University of Health and Welfare Tokyo Japan.
Laryngoscope Investig Otolaryngol. 2022 May 25;7(3):799-806. doi: 10.1002/lio2.806. eCollection 2022 Jun.
Treatments for unilateral vocal fold paralysis (UVFP) include conservative voice rehabilitation, vocal fold injection, and laryngeal framework surgery. We proposed basic fibroblast growth factor (bFGF) injection as a potential novel treatment for UVFP and have reported the short-term results. In this study, we present the long-term results and safety of vocal fold bFGF injection as a treatment for UVFP.
This retrospective study included 42 patients (25 males and 17 females) with UVFP who were administered a local injection of bFGF. The injection regimen involved injecting FGF (0.5 μg/ml in 0.5 ml per side) into the bilateral vocal folds using a 23-gauge injection needle. Phonological outcomes were evaluated 6 months and 12 months after the injection.
Overall, 26 patients received a single injection of bFGF, six patients received an additional injection, and 10 patients received the additional framework surgery. Maximum phonation time, mean flow rate, pitch range, jitter and shimmer percentages, the total GRBAS (grade, roughness, breathiness, asthenia, strain) score, and voice handicap index scores improved significantly in the long term. In patients who received the additional injection or framework surgery, the effects of bFGF injection were temporary, but did not interfere with the performance of the framework surgery.
In total, 42 patients who underwent vocal fold bFGF injections were reviewed. The bFGF injections were effective and safe in the long-term results for UVFP in the selected cases. Some patients with severe symptoms benefited from the additional framework surgery but not the additional bFGF injection.
单侧声带麻痹（UVFP）的治疗方法包括保守的嗓音康复、声带注射和喉框架手术。我们提出将碱性成纤维细胞生长因子（bFGF）注射作为UVFP的一种潜在新疗法，并报告了短期结果。在本研究中，我们展示了声带bFGF注射治疗UVFP的长期结果和安全性。
这项回顾性研究纳入了42例接受bFGF局部注射的UVFP患者（25例男性和17例女性）。注射方案包括使用23号注射针将FGF（每侧0.5 ml，浓度为0.5 μg/ml）注射到双侧声带。在注射后6个月和12个月评估语音结果。
总体而言，26例患者接受了单次bFGF注射，6例患者接受了额外注射，10例患者接受了额外的框架手术。最大发声时间、平均流速、音调范围、抖动和闪烁百分比、GRBAS（分级、粗糙度、气息声、无力、紧张）总分以及嗓音障碍指数评分长期来看均有显著改善。接受额外注射或框架手术的患者中，bFGF注射的效果是暂时的，但不影响框架手术的实施。
总共对42例接受声带bFGF注射的患者进行了评估。在所选病例中，bFGF注射对UVFP的长期结果是有效且安全的。一些症状严重的患者从额外的框架手术中获益，但额外的bFGF注射未使其受益。
