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Predictors of Voice Improvement After Intracordal Trafermin Injection in Vocal Fold Paralysis
Tomohiro Hasegawa1,2, Larbi Aluariachy3, Retsu Fujita3
1Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
The Laryngoscope
|July 17, 2025
Summary
Pre-injection voice measures like maximum phonation time (MPT), pitch range (PR), and mean flow rate (MFR) can predict the success of intracordal trafermin injections for vocal fold paralysis, aiding treatment decisions.
Area of Science:
- Otolaryngology
- Speech and Language Pathology
Background:
- Unilateral vocal fold paralysis often requires multiple treatments due to variable voice improvement after intracordal trafermin injection.
- Identifying predictive factors for treatment efficacy is crucial for optimizing patient management.
Purpose of the Study:
- To identify pre-injection factors that predict the effectiveness of intracordal trafermin injection for unilateral vocal fold paralysis.
- To guide clinical decision-making for patients undergoing this treatment.
Main Methods:
- Retrospective analysis of 143 patients with unilateral vocal fold paralysis treated with intracordal trafermin injection.
- Evaluation of pre-injection factors including maximum phonation time (MPT), pitch range (PR), and mean flow rate (MFR).
- Comparison of voice parameters between patients who did and did not require additional treatment post-injection.
Main Results:
- Significant differences were observed in MPT, PR, and MFR between groups requiring additional treatment and those not requiring it (p < 0.01, 0.02, 0.01 respectively).
- Established cutoff values for MPT (3.25s), PR (20.5 semitones), and MFR (597.8 mL/s) as predictors of treatment success.
- Logistic regression did not reveal significant differences in other evaluated factors.
Conclusions:
- Pre-injection MPT, PR, and MFR are valuable indicators for predicting the outcome of intracordal trafermin injection in unilateral vocal fold paralysis.
- These objective measures can assist clinicians in determining the suitability and expected success of the injection, potentially avoiding unnecessary interventions.
