일측성 성대마비 환자에서 Cross-Linked Hyaluronic Acid Gel을이용한 성대주입술의 효과 및 안전성
Cross-Linked Hyaluronic Acid Gel Injection for the Patients withUnilateral Vocal Cord Paralysis
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Abstract
Background and Objectives：Hyaluronic acid (HA) is a natural polysaccharide, which resides in the extracellular space of all mammalian connective tissue and creates viscoelasticity, hydrating, lubricating and stabilizing matrix. The authors aimed to determine the clinical efficacy and safety of using HA derivative as an injection material to correct the glottal insufficiency of patients with unilateral vocal cold palsy (VCP). Subjects and Method：Twenty-eight consecutive patients with recent unilateral VCP received percutaneous HA derivative (Rofilan) injections under local anesthesia. Acoustic, aerodynamic and stroboscopic analyses were prospectively provided for the 14 subjects prior to the injection, and 1 week and 3 months after the injection. Perceptual GRBAS grading by speech language pathologists and subjective ratings of the hoarseness and aspiration by the patients were also obtained. Results：Acoustic (jitter and shimmer) and aerodynamic (maximal phonation time) parameters were significantly improved after the injection (p<0.05). Perceptual grading and subjective scaling also showed significant improvement. Those beneficial effects could be maintained for longer than 3 months but with a tendency of losing their effects with time. Early or delayed significant side effects were not observed. Conclusion：Vocal fold injection with HA derivative is a convenient, safe and useful method of correcting glottal insufficiency for more than 3 months. The patients with recently developed unilateral VCP with unknown possibility of recovery would be suitable candidates for HA injection. Further long-term follow-up studieswill answer the durability of the HA injection effect.
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