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Multidimensional assessment of voice quality after injection augmentation of the vocal fold with autologous adipose tissue or calcium hydroxylapatite

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate short- and long-term outcome of injection augmentation with autologous adipose tissue (AAT) and calcium hydroxylapatite injection (CAHA) in patients with a unilateral vocal fold paralysis (UVFP).

Design/methods

A retrospective cohort study was performed in patients diagnosed with UVFP, who had received injection augmentation with AAT or CAHA. Multidimensional voice analysis was performed before, 3 and 12 months after injection. This analysis included patient self-assessment (Voice Handicap Index-30), perceptual (overall dysphonia grade according to the GRBAS scale), aerodynamic (MPT, s/z ratio) and acoustic (fundamental frequency, dynamic range) parameters. Effects were assessed using a linear mixed model analysis.

Results

Forty-six patients were available for evaluation, with a total of 53 injection augmentations (AAT n = 39; CAHA n = 14). We found significant improvement of patient self-assessment and perceptive voice outcome at 3 months, which were maintained at 12 months. In the CAHA group, s/z ratio and dynamic range of extreme frequencies also improved significantly over time. No statistically significant differences were found between the two treatments (AAT vs. CAHA). No major complications were reported.

Conclusion

This study, using a guide-line recommended panel of outcome parameters, shows a high success rate of injection augmentation with AAT or CAHA for patients with UVFP at 12 months with significant improvement in most voice outcome parameters, although voices do not completely normalize. There is no significant difference in outcome between the two materials.

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Data availability

Data are available on reasonable request via corresponding author.

Code availability

Not applicable.

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Acknowledgements

The authors would like to thank Mrs. V.A.H. van de Kamp for her assistance in collecting voice data and voice evaluation.

Funding

None of the authors received any funding to conduct this study.

Author information

Authors and Affiliations

  1. Department of ENT, Head and Neck Surgery H5-Q, Leiden University Medical Center, Albinusdreef 2, Postbus 9600, 2300 RC, Leiden, The Netherlands

    Stephanie D. Mes, Bas J. Heijnen, Martine Hendriksma, Jeroen C. Jansen, Antonius P. M. Langeveld & Elisabeth V. Sjögren

  2. Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands

    Edela Smajlović

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  1. Stephanie D. Mes
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Contributions

SDM, BJH, APML and EVS contributed to study concept and design; SDM and ES collected data; SDM and MH were involved in analysis; SDM, MH, EVS and BJH contributed to interpretation and implications of results; SM and EVS drafted the manuscript; all the authors were involved in critical revision of the manuscript and final approval.

Corresponding author

Correspondence to Stephanie D. Mes.

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The authors have no conflicts of interest to declare.

Ethical approval

This study was approved by the local medical ethical committee code G17.118.

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Mes, S.D., Smajlović, E., Heijnen, B.J. et al. Multidimensional assessment of voice quality after injection augmentation of the vocal fold with autologous adipose tissue or calcium hydroxylapatite. Eur Arch Otorhinolaryngol 279, 1967–1978 (2022). https://doi.org/10.1007/s00405-021-07193-7

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  • DOI: https://doi.org/10.1007/s00405-021-07193-7

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