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Office-Based Injection Laryngoplasty in Patients with High Vagal Paralysis

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Objective: High vagal paralysis (HVP) is a type of vocal-fold paralysis, associated with discoordination of the pharyngeal musculature, and the failure of the cricopharyngeus muscle to relax, leading to swallowing disability. We evaluated the difference between the functional results of office-based injection laryngoplasty and medialization thyroplasty in patients with unilateral vocal cord paralysis caused by HVP. Methods: A retrospective review of 28 patients following laryngoplasty with HVP was performed. Pre- and posttreatment swallowing and voice functions were reviewed. Results: Seventeen patients underwent injection laryngoplasties, while 11 received medialization thyroplasties. In both groups, all except one patient who received medialization thyroplasty recovered their ability to swallow after appropriate procedures (100% vs. 91%). An acoustic analysis demonstrated significant changes in shimmer, noiseto- harmonic ratio, and maximum phonation time (MPT) in the injection laryngoplasty group, whereas significant changes in jitter and MPT were observed in the medialization thyroplasty group. Conclusion: Office-based injection laryngoplasty was found to be an effective and reliable therapy for improving swallowing and voice function in patients with HVP, compared to medialization thyroplasty.

Abstract

Objective: High vagal paralysis (HVP) is a type of vocal-fold paralysis, associated with discoordination of the pharyngeal musculature, and the failure of the cricopharyngeus muscle to relax, leading to swallowing disability. We evaluated the difference between the functional results of office-based injection laryngoplasty and medialization thyroplasty in patients with unilateral vocal cord paralysis caused by HVP. Methods: A retrospective review of 28 patients following laryngoplasty with HVP was performed. Pre- and posttreatment swallowing and voice functions were reviewed. Results: Seventeen patients underwent injection laryngoplasties, while 11 received medialization thyroplasties. In both groups, all except one patient who received medialization thyroplasty recovered their ability to swallow after appropriate procedures (100% vs. 91%). An acoustic analysis demonstrated significant changes in shimmer, noiseto- harmonic ratio, and maximum phonation time (MPT) in the injection laryngoplasty group, whereas significant changes in jitter and MPT were observed in the medialization thyroplasty group. Conclusion: Office-based injection laryngoplasty was found to be an effective and reliable therapy for improving swallowing and voice function in patients with HVP, compared to medialization thyroplasty.

참고문헌 (10)

  1. Haapaniemi JJ, "Botulinum toxin in the treatment of cricopharyngeal dysphagia", Dysphagia, 16, pp.171~175 (2001)[DOI]
  2. Damrose EJ, "Advances in the management of glottic insufficiency", Curr Opin Otolaryngol Head Neck Surg, 11, pp.480~484 (2003)[DOI]
  3. Fang TJ, "Unilateral high vagal paralysis : relationship of the severity of swallowing disturbance and types of injuries", Laryngoscope, 121, pp.245~249 (2011)[DOI]
  4. Thakar A, "Cricothyroid approximation for voice and swallowing rehabilitation of high vagal paralysis secondary to skull base neoplasms", Eur Arch Otorhinolaryngol, 268, pp.1611~1616 (2011)[DOI]
  5. Brunings W, "Uber eine neue Behandelungsmethode der Rekurrenslamung Verhandl", Ver Dtsch Laryngol, 18, pp.93~151 (1911)[DOI]
  6. Kwon TK, "Injection laryngoplasty for management of unilateral vocal fold paralysis", Curr Opin Otolaryngol Head Neck Surg, 12, pp.538~542 (2004)[DOI]
  7. Arnold GE, "Vocal rehabilitation of paralytic dysphonia IX", Technique of intracordal injection, 76, pp.358~368 (1962)[DOI]
  8. Isshiki N, "Thyroplasty as a new phonosurgical technique", Acta Otolaryngol, 78, pp.451~457 (1974)[DOI]
  9. Bielamowicz S, "Perspectives on medialization laryngoplasty", Otolaryngol Clin North Am, 37, pp.139~160 (2004)[DOI]
  10. Billante CR, "Voice gains following thyroplasty may improve over time", Clin Otolaryngol Allied Sci, 27, pp.89~94 (2002)[DOI]

관련 논문AI추천

Effects of Injection Laryngoplasty on Swallowing Outcomes in Unilateral Vocal Fold ParalysisChung Seung Hyun, Kim Ja Young, Ryu Chang Hwan, Ryu Youn Mi대한후두음성언어의학회 · 대한후두음성언어의학회지2025 · 제36권 제3호Early Injection Laryngoplasty With a Long-Lasting Material in Patients With Potentially Recoverable Unilateral Vocal Fold Paralysis김학정, 손영익, 진호경, 최나연대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2019 · 제12권 제4호Comparative Analysis of Efficiency of Injection Laryngoplasty Technique for with or without Neck Treatment Patients: A Transcartilaginous Approach Versus the Cricothyroid Approach고윤우, 김재욱, 손영익, 심성신, 이승원대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2010 · 제3권 제1호The Investigation of Hyaluronic Acid (The Chaeum Premium No.2®) to Evaluate the Efficacy and Safety for Injection Laryngoplasty in Unilateral Vocal Cord Paralysis: A Single Center, Phase II TrialKim Min-Su, Park JunHo대한후두음성언어의학회 · 대한후두음성언어의학회지2024 · 제35권 제1호일측 성대마비 환자에 대해 음성치료와 성대주입술의 초기 치료 효과 비교 연구장현, 손희영, 안수연, 이창윤대한후두음성언어의학회 · 대한후두음성언어의학회지2017 · 제28권 제2호Real-Time Light-Guided Vocal Fold Injection via the Cricothyroid Membrane in Unilateral Vocal Fold Paralysis: A Human Pilot Study허진, 정우진, 차원재, 한승훈, Pil Geun Jang, Ramla Talib Mohammad대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2022 · 제15권 제3호

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