Early hyaluronate injection improves quality of life but not neural recovery in unilateral vocal fold paralysis: An open-label randomized controlled study

Abstract

Purpose: To investigate the neurologic and functional effect of intracordal hyaluronate injections in acute unilateral vocal fold paralysis (UVFP) in a randomized controlled trial. Methods:In this open-label, randomized controlled study, 29 patients with UVFP were recruited within 6 months of their first outpatient visit and were randomized to receive either single hyaluronate injection (HI group) or conservative management (CM group). Quantitative laryngeal electromyography, videolaryngostroboscopy, UVFP-related quality of life (Voice Outcomes Survey, VOS), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1, 3 and 6 months post-injection in the HI group, and at baseline and 6 months in the CM group. Results: Improvements in most quality of life domains and other assessments were comparable between the HI and CM groups; however, the HI group had a greater improvement in the mental health domain of quality of life at the end of follow-up. Conclusions: Early hyaluronate injection cannot improve nerve regeneration but can result in long-lasting improvements in patients' psychosocial well-being, thus highlighting the importance of early intervention for patients with UVFP.

Early‐injection laryngoplasty may lower risk of thyroplasty: A systematic review and meta‐analysis

“…Our findings are consistent with prior studies that have shown a benefit to early-injection laryngoplasty in patients with UVFP, including improvements in short-term quality of life, 21,22 voice quality, 23 and acoustic parameters. 24 Furthermore, others also have theorized that early-injection laryngoplasty would lead to a decrease in the rate of future thyroplasty based on their own retrospective studies.…”

Effect of injection augmentation on need for framework surgery in unilateral vocal fold paralysis

“…This corroborates recent findings from the Pei et al open-label randomized trial in which early hyaluronate injection did not improve nerve regeneration, but it made a significant impact on patient quality of life. 19 Several previous studies have considered this relationship. Yung et al found that 26% (5/19) of patients injected versus 66% (23/35) of patients not injected ultimately required definitive type I laryngoplasty.…”

The impact of cricothyroid involvement on adductor recovery in unilateral vocal fold paralysis

“…The study patients were free to choose the treatment options as observation or underwent hyaluronate injection laryngoplasty (HIL) for their initial symptoms, as described previously . For HIL, patients were seated upright without sedation, and lidocaine spray was administered into their mouth and nose until numbness was experienced.…”

“…Quantitative LEMG that measures the turn frequency has recently provided additional information on laryngeal neuromuscular activity . Evaluating TA‐LCA muscle complex activity using quantitative LEMG at multiple time points can objectively evaluate the recovery …”