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Published on: December 1, 2023
Voice Outcomes and Reinjection Rates After Injection Laryngoplasty in Vocal Fold Paralysis Following Thyroidectomy
Oh-Hyeong Lee1, Jung-Hae Cho1, Juhui Jeong1
1Department of Otorhinolaryngology-Head and Neck Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
Summary
Vocal fold paralysis from thoracic surgery leads to worse voice outcomes and requires more frequent, earlier reinjection compared to thyroidectomy-induced paralysis. Initial mean flow rate predicts reinjection needs.
Area of Science:
- Otolaryngology
- Thoracic Surgery
- Voice Science
Background:
- Vocal fold paralysis is a known complication of thyroidectomy and thoracic surgery.
- Comparative data on injection laryngoplasty outcomes for these etiologies are limited.
Purpose of the Study:
- To compare voice outcomes and reinjection patterns after hyaluronic acid injection laryngoplasty in patients with unilateral vocal fold paralysis secondary to thyroidectomy versus thoracic surgery.
Main Methods:
- Retrospective cohort study of 141 patients undergoing hyaluronic acid injection laryngoplasty.
- Assessment of acoustic, perceptual, and patient-reported voice outcomes pre-injection and up to 12 months post-injection.
- Analysis of reinjection rates, time to reinjection, and predictors of reinjection.
Main Results:
- Thoracic surgery group had worse baseline voice parameters and outcomes post-injection compared to the thyroidectomy group.
- Higher reinjection rates (30.8% vs 15.8%) and shorter intervals to reinjection (median 36 vs 142 days) were observed in the thoracic surgery group.
- Initial mean flow rate was the sole independent predictor of reinjection (aOR 1.26; P=0.044).
Conclusions:
- Vocal fold paralysis post-thoracic surgery presents with more severe impairment, poorer long-term voice outcomes, and increased need for earlier reinjection.
- Initial mean flow rate can guide individualized management strategies for injection laryngoplasty.
- Early laryngological referral and proactive monitoring are recommended for patients with thoracic surgery-induced vocal fold paralysis.
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