[IN-OFFICE VOCAL CORD INJECTION FOR TREATMENT OF DYSPHONIA]

Dysphonia significantly damages quality of life and employment opportunities. One of the common causes of hoarseness is glottic insufficiency, namely the lack of full adherence of the vocal cords during speech and swallowing. Correction is achieved by vocal cord medialization.

To examine the effect of vocal cord injection with carboxymethyl cellulose and hydroxyapatite under local anesthesia in the office, on the voice objectively, assessment by staff and patient satisfaction.

This prospective and retrospective study included 38 vocal cord injections: 30 involved carboxymethyl cellulose injections, and 8 were injected with hydroxyapatite. Objective and subjective parameters were collected before the injection and 1-2 weeks after the injection.

Average subjective disturbance of the voice decreased from 5.9 to 4.1 post-injection (p<0.01). Average Voice Handicap Index (VHI) decreased from 75.3 to 39.1 (p<0.01) and average Glottic Function Index (GFI) decreased from 15.7 to 9.5 (p<0.01). Average GRABS decreased from 11.9 to 6 (p<0.01) and average visual analogue scale decreased from 4 to 2.5 (p<0.01). Average Maximal Phonation Time increased from 6.9 to 9 sec (p=0.1). Average S/Z ratio decreased from 1.8 to 1.3 (p=0.1). Voice analysis showed average jitter decreased from 2.4% to 0.8% (p<0.01) and average shimmer from 10.9% to 5% (p<0.01).

Vocal cord injection under local anesthesia in the office is a good and safe method for treating glottic insufficiency. Vocal cord injection with carboxymethyl cellulose and hydroxyapatite improves objective and subjective voice properties.