Vocal fold augmentation with calcium hydroxylapatite: twelve-month report

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Regenerative Medicine

Background:

• Glottal insufficiency, often caused by vocal fold paralysis or immobility, significantly impacts voice quality and patient well-being.
• Vocal fold injection augmentation aims to restore glottal closure and improve phonation.

Purpose of the Study:

• To assess the long-term (12-month) efficacy of calcium hydroxylapatite (CaHA) vocal fold injection for treating glottal insufficiency.
• To evaluate patient-reported outcomes and objective voice measures following CaHA injection.

Main Methods:

• A multicenter, open-label, prospective study was conducted with 63 patients.
• Patients served as their own controls, with voice assessments at baseline and 1, 3, 6, and 12 months post-injection.
• Outcome measures included patient satisfaction, Voice Handicap Index-10, visual analog scale for vocal effort, perceptual voice evaluation, and objective measures like maximum phonation time and S:Z ratio.

Main Results:

• Significant improvements in voice quality and glottal closure were observed at 12 months post-injection.
• 67% of patients reported significant voice improvement, and 81% reported at least moderate improvement.
• Objective voice measures and perceptual evaluations demonstrated significant post-treatment gains, with a 22% re-treatment rate at 12 months.

Conclusions:

• Calcium hydroxylapatite vocal fold injection is an effective treatment for glottal insufficiency, yielding excellent clinical results at one year.
• The study supports CaHA as a viable option for improving voice function in patients with vocal fold paralysis and glottal incompetence.