Therapeutic Efficacy of Basic Fibroblast Growth Factor in Patients With Vocal Fold Atrophy

Abstract

Objectives/Hypothesis: In recent years, basic fibroblast growth factor (bFGF) injection has been used in the treatment of aging-related vocal fold atrophy. This injection not only improves closure by increasing the mass of the vocal fold but also improves its viscoelasticity. However, it has been reported that fibroblasts targeted by bFGF treatment decrease in number with age. The purpose of this study was to examine the effects of local injection of bFGF on age-related vocal atrophy as well as the influence of age on phonological outcomes. Study Design: Retrospective chart review. Methods: Fifty-three patients with age-related vocal fold atrophy underwent single injections of bFGF in their vocal folds. Phonological outcomes were evaluated 3 and 6 months after injection by acoustic and aerodynamic measurements. Results: Voice Handicap Index (VHI), maximum phonation time (MPT), jitter, shimmer, and pitch range improved after injection, and the effects continued for 6 months. In those over 70 years of age, VHI and MPT showed improvement at 3 and 6 months after injection. In addition, the degree of improvement in VHI and MPT did not differ significantly between those older than 70 years and those younger than 70 years. Conclusions: Regenerative treatments dependent on bFGF single injection was safe and effective for both early and late elderly patients suffering of vocal fold atrophy.

Intracordal injection therapy for vocal fold scarring: Steroid versus basic fibroblast growth factor

“… 32 bFGF injection has become a leading treatment for vocal fold atrophy and paralysis. 18 , 19 , 21 The efficacy of bFGF in the treatment of vocal fold scarring and atrophy has been demonstrated in several animal and clinical studies. 22 , 23 , 25 , 26 In another study, 41 patients with vocal fold scarring were treated with four injections of bFGF and showed improvement in MPT and GRBAS score.…”

“…bFGF has been found to improve MPT and MFR in patients with vocal fold paralysis and atrophy with a large insufficiency. 18 , 21 Thus, bFGF might mediate a medialization effect related to MPT and MFR by stimulating the SLP and underlying muscle layer and simultaneously improve the vibratory properties of the vocal folds. This hypothesis might be supported by our finding of a decrease in SFF following bFGF injection.…”

“…Basic fibroblast growth factor (bFGF) is among the most commonly used growth factors and is already being used to treat various vocal fold lesions. 18 , 19 , 20 , 21 However, few studies have investigated the therapeutic effects of bFGF on phonological function in patients with vocal fold scarring. 18 bFGF administration can stimulate fibroblast proliferation and promote synthesis of extracellular matrix, leading to increased hyaluronic acid and matrix metalloproteinase production and reduced collagen deposition, thereby increasing the thickness of the superficial lamina propria (SLP).…”

Long‐term results and safety of fibroblast growth factor injection for unilateral vocal fold paralysis

“…The delivery of external growth factors is a simple method that has been attempted in several fields 12 . In particular, bFGF—one of the major growth factors—has been used to treat vocal fold lesions 10,13–16 . bFGF injection stimulates the hyaluronic acid production and inhibits collagen production by proliferating the reduced fibroblasts in the superficial lamina propria (SLP) of atrophic vocal folds.…”

“… 12 In particular, bFGF—one of the major growth factors—has been used to treat vocal fold lesions. 10 , 13 , 14 , 15 , 16 bFGF injection stimulates the hyaluronic acid production and inhibits collagen production by proliferating the reduced fibroblasts in the superficial lamina propria (SLP) of atrophic vocal folds. This increases the thickness of the SLP, thereby improving the symptoms of dysphonia caused by vocal atrophy and sulcus vocalis.…”