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Effect of Treatment Timing on Voice Outcomes After Intracordal Trafermin Injection for Vocal Fold Paralysis Following
Mariko Terasaki1, Tomohiro Hasegawa1, Ryota Iinuma1
1Department of Otolaryngology-Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
Objective:
We aimed to investigate the relationship between the timing of intracordal trafermin injection (ITI) and subsequent voice improvement in patients with unilateral vocal fold paralysis (UVFP) following surgery for aortic disease.
Methods:
This retrospective single-institution study included 50 patients (8 women and 42 men; mean age, 65.22 years) who underwent ITI at the Tokyo Voice Center between 2015 and 2025. Clinical variables, including age, sex, injection dose, and preinjection and postinjection voice parameters (maximum phonation time (MPT), pitch range (PR), mean flow rate (MFR), and voice handicap index (VHI)), were analyzed. The primary endpoints were the interval from UVFP onset to ITI and voice improvement. Analysis of covariance and correlation were performed to identify factors associated with postinjection voice outcomes.
Results:
The mean interval from aortic surgery to ITI was 339.76 ± 523.96 days. Significant associations were observed between injection dose and MPT (P = 0.027), preinjection PR and PR improvement (P < 0.01), and both injection dose and preinjection MFR with MFR (P < 0.01). Preinjection VHI was significantly associated with postinjection VHI (P < 0.01). Correlation analysis (excluding cases with >500 days to ITI) demonstrated weak negative correlations between time to ITI and voice outcomes (MPT: R = -0.323; PR: R = -0.231; MFR: R = -0.103; VHI: R = -0.381).
Conclusion:
Earlier ITI may be associated with greater voice improvement, although the correlations were weak. Further studies with larger sample sizes are required to clarify the optimal timing of intervention.
