Single Platelet Rich Plasma Glottic Injections in Vocal Pathology Demonstrate Long Term Benefits

Platelet rich plasma (PRP) injection of the vocal folds (VF) is increasingly recognized as beneficial for VF pathologies. We examined how the number of PRP injections impacted voice outcomes in patients with VF pathologies excluding malignancy.

Patients undergoing PRP VF injections were followed prospectively (1, 3, 6, and 12 months) with examination, perceptual ratings, videostroboscopy, and completed questionnaires (Voice Handicap Index-10 [VHI-10], Vocal Fatigue Index [VFI]), rating improvement, and willingness to repeat PRP injection. Patients underwent between 1 and 7 PRP injections under local anesthetic in the office. Comparison of outcomes for single versus multiple doses of PRP was undertaken.

Eighty-three individuals (60% female) received 123 PRP injections. Fifty-four participants (65%) had single injections, and 29 had 2-7 injections. Mean difference between pre-injection and 12-month VHI-10 for single and multiple injections was reduction of 6.95 (SD 4.8) and 8.2 (SD 13.4) respectively. There was no statistically significant difference in change in VHI-10 from baseline to 12 months (p = 0.71), 6 months (p = 0.74), or 3 months (p = 0.23) comparing single versus multiple injection groups. There was no difference in "improvement of VHI-10" or VFI between single versus multiple injection groups. Individuals with VF scar or previous procedures were more likely to require more than one PRP injection.

Single PRP injection of the VF can provide significant improvement in vocal parameters in individuals with benign VF pathology out to 12 months. Additional PRP injections following an index injection should be considered on a case-by-case basis for patients where initial effects fade or additional benefit is desired.