Auto-crosslinked hyaluronan gel injections in phonosurgery

Area of Science:

• Otolaryngology
• Regenerative Medicine
• Biomaterials Science

Background:

• Vocal fold (VF) scarring, atrophy, and sulcus vocalis present significant challenges in voice restoration.
• Existing treatments for VF defects may have limitations in efficacy and safety.

Purpose of the Study:

• To evaluate the clinical performance and tolerability of an auto-crosslinked gel (ACP-based gel) derived from hyaluronic acid.
• To assess its utility as an anti-adhesive and/or augmentative agent in vocal cord surgery for various VF conditions.

Main Methods:

• Prospective multicenter trial (2007-2009) involving 40 patients with glottic gap, VF scars, atrophy, or sulcus vocalis.
• Endoscopic injection of ACP-based gel into the thyroarytenoid muscle or lamina propria.
• Voice evaluation protocol conducted pre-surgery, at 3 months, and 12 months post-surgery.

Main Results:

• Statistically significant improvements in voice parameters were observed at both 3-month and 12-month follow-ups compared to baseline.
• No perioperative or postoperative side effects, including hematoma, infection, or allergic reactions, were reported.
• 38 patients had 3-month follow-up data, and 27 patients had 12-month follow-up data.

Conclusions:

• ACP-based gel demonstrates potential as a novel therapeutic tool for vocal fold scarring, acting as both an anti-adhesive and augmentation agent.
• The study observed improvements in all glottal parameters and both objective and subjective voice performance evaluations.
• ACP-based gel appears to be a safe and effective option for managing vocal fold defects.