Tissot Laura, Fabre Christol, Aboussouan Marie-Pierre, Castellanos Paul F, Atallah Ihab
Otolaryngology-Head & Neck Surgery Department Grenoble Alpes University Hospital Grenoble France.
School of Medicine Grenoble Alpes University Grenoble France.
World J Otorhinolaryngol Head Neck Surg. 2024 Sep 2;11(2):232-240. doi: 10.1002/wjo2.212. eCollection 2025 Jun.
Augmentation laryngoplasty represents a therapeutic choice for patients who suffer from glottic insufficiency of different etiologies. There have been multiple injectables that have been proven effective. The present study examines the short-term effects of vocal fold augmentation on phonation, swallowing, and breathing in individuals with glottic insufficiency. In addition, a decision plan is also proposed.
Data from medical records and operative notes were used to conduct a retrospective cohort study on patients with glottic insufficiency who underwent vocal fold augmentation from 2016 to 2023. Hyaluronic acid, calcium hydroxyapatite, and polydimethylsiloxane were the injectable materials that were used. An analysis was conducted on phonation, breathing, swallowing, and laryngoscopy findings both before and after vocal folds' augmentation.
Seventy-nine patients were included, which represents 97 injections. The median (IQR) preoperative Voice Handicap Index-10 (VHI-10) score improved from 21 (15-28) to 16 (9-25) postoperatively ( < 0.001). The GRBAS scale also significantly decreased ( < 0.001). The median (IQR) preoperative Dyspnea Index score improved from 6 (0-17) to 2 (0-10) postoperatively ( < 0.05). Laryngoscopic findings showed significant improvement in the bulk of the vocal folds. There was no significant change in swallowing.
In case of dysphonia secondary to glottic insufficiency, augmentation laryngoplasty using various injectable materials has proven to be an effective option across a range of different etiologies, as it results in significant improvements in voice quality. The choice of the injectable material depends upon the severity and the etiology of glottic insufficiency.
对于患有不同病因声门闭合不全的患者，喉成形术是一种治疗选择。已有多种注射材料被证明有效。本研究探讨声门闭合不全患者声带注射填充术对发声、吞咽和呼吸的短期影响。此外，还提出了一个决策方案。
利用病历和手术记录数据，对2016年至2023年接受声带注射填充术的声门闭合不全患者进行回顾性队列研究。使用的注射材料为透明质酸、羟基磷灰石钙和聚二甲基硅氧烷。对声带注射填充术前和术后的发声、呼吸、吞咽及喉镜检查结果进行分析。
纳入79例患者，共进行了97次注射。术前嗓音障碍指数-10（VHI-10）评分中位数（四分位间距）从21（15 - 28）改善至术后的16（9 - 25）（<0.001）。GRBAS量表评分也显著降低（<0.001）。术前呼吸困难指数评分中位数（四分位间距）从6（0 - 17）改善至术后的2（0 - 10）（<0.05）。喉镜检查结果显示声带体积有显著改善。吞咽功能无显著变化。
对于声门闭合不全继发的发音障碍，使用各种可注射材料进行喉成形术已被证明是一种有效的选择，适用于一系列不同病因，因为它能显著改善嗓音质量。可注射材料的选择取决于声门闭合不全的严重程度和病因。
