Augmentation laryngoplasty: Results and decision plan

Area of Science:

• Otolaryngology
• Speech and Hearing Science
• Regenerative Medicine

Background:

• Glottic insufficiency can result from various etiologies, impacting phonation, swallowing, and breathing.
• Augmentation laryngoplasty offers a therapeutic option for glottic insufficiency.
• Several injectable materials have demonstrated efficacy in vocal fold augmentation.

Purpose of the Study:

• To evaluate the short-term effects of vocal fold augmentation on phonation, swallowing, and breathing.
• To analyze the impact of different injectable materials on vocal fold function.
• To propose a decision plan for selecting appropriate injectable materials.

Main Methods:

• Retrospective cohort study of 79 patients (97 injections) with glottic insufficiency from 2016-2023.
• Utilized hyaluronic acid, calcium hydroxyapatite, and polydimethylsiloxane for vocal fold augmentation.
• Assessed phonation (VHI-10, GRBAS), breathing (Dyspnea Index), and swallowing pre- and post-augmentation.

Main Results:

• Significant improvement in voice quality, indicated by decreased VHI-10 (21 to 16) and GRBAS scores (p < 0.001).
• Significant improvement in breathing function, with reduced Dyspnea Index scores (6 to 2, p < 0.05).
• Laryngoscopy revealed enhanced vocal fold bulk; no significant changes in swallowing function were observed.

Conclusions:

• Augmentation laryngoplasty is effective for treating dysphonia due to glottic insufficiency across diverse etiologies.
• Significant improvements in voice and breathing are achieved post-procedure.
• The selection of injectable material should be guided by the severity and etiology of glottic insufficiency.