In-Office Hyaluronic Acid Injection of Vocal Folds in Patients with Presbyphonia

Objective: to evaluate the advantages and disadvantages of injection laryngoplasty with hyaluronic acid in patients older than 65 years with presbyphonia. Study Design: a retrospective observational study. Setting: an academic secondary medical center. Methods: This study was performed using a group of patients diagnosed with presbyphonia who were treated using injection laryngoplasty with hyaluronic acid and underwent a minimum follow-up of 12 months. Subjective parameters such as the Voice Handicap Index-10 (VHI-10) and the GRBAS scale (grade, roughness, breathiness, asthenia, strain) were measured, as well as objective parameters such as the closure defect area. The medical records of patients undergoing this procedure during the 2020-2023 period were reviewed. An analysis of the demographic and clinical variables of the group was performed, as well as the values of the VHI-10, GRBAS, difference, and improvement of the area of closure defect before and after the procedure, along with the treatment duration and sensation of improvement. Results: The mean pre- and postoperative VHI-10 decreased from 26.8 to 19.6, showing significant differences (p = 0.007). The postoperative GRBAS mean score was 5.6 and normality can be assumed when it is below 9. Out of the 16 patients, 11 of them reported subjective improvement in their symptoms. More than half of them showed an improvement in the closure defect greater than 80%, with a significant reduction in the area (p < 0.001). Conclusions: hyaluronic acid injection in patients with presbyphonia produced a clear subjective improvement in voice quality and a decrease in the closure defect area.