Document Detail


Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis--preliminary results.
MedLine Citation:
PMID:  21816569     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study is to investigate the feasibility of using an injectable needle electrode to guide hyaluronic acid (HA) vocal fold injection (VFI) during laryngeal electromyography (LEMG) for unilateral vocal fold paralysis (UVFP).
STUDY DESIGN: Prospective study.
METHODS: From March to June 2010, 20 UVFP patients received LEMG examination at our clinic. Before completion of LEMG, 1.0 cc of HA (Restylane Perlane(®); Q-Med, Uppsala, Sweden) was injected via a 26-gauge monopolar injectable needle electrode into paralyzed thyroarytenoid muscle. After injection, 20 patients completed 3-months follow-up and 16 patients completed 6-months follow-up. The data before, 1 week, 3 months, and 6 months after injection, including the normalized glottal gap area (NGGA) from videostroboscopy, maximal phonation time (MPT), mean airflow rate (MAFR), phonation quotient (PQ), perceptual evaluation of voice (grade, roughness, breathiness, asthenia, strain [GRBAS] scale), Voice Handicap Index (VHI), and self-grading of choking (grade 1-7), were analyzed by the Wilcoxon signed rank test.
RESULTS: All of the patients completed the procedure without complications. After injection, mean NGGA was significantly reduced from 8.28 units to 0.52 units (1 week), 1.79 units (3 months), and 1.36 units (6 months). The mean MPT was prolonged from 5.66 seconds to 11.73, 11.25, and 11.93 seconds, respectively. VHI was reduced from 76.05 to 38.10, 37.40 and 35.00, respectively. Other analyzed data (PQ, MAFR, GRBAS scale, and choking severity) also showed statistically significant improvement.
CONCLUSION: LEMG-guided HA VFI provides UVFP patients with neuromuscular function evaluation and treatment in one step. This clinical technique is feasible, and the short-term results are satisfactory.
Authors:
Chen-Chi Wang; Ming-Hong Chang; Ching-Ping Wang; Shi-An Liu; Kai-Li Liang; Shang-Heng Wu; Rong-San Jiang; Hui-Tsu Huang; Hsiu-Chin Lai
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-08-04
Journal Detail:
Title:  Journal of voice : official journal of the Voice Foundation     Volume:  26     ISSN:  1873-4588     ISO Abbreviation:  J Voice     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-11-16     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  8712262     Medline TA:  J Voice     Country:  United States    
Other Details:
Languages:  eng     Pagination:  506-14     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Medicine, National Yang-Ming University, Taipei, Taiwan. entccwang@msn.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Electrodes
Electromyography
Feasibility Studies
Female
Humans
Hyaluronic Acid / administration & dosage*
Injections
Larynx / physiology
Male
Middle Aged
Prospective Studies
Thyroidectomy / adverse effects
Viscosupplements / administration & dosage*
Vocal Cord Paralysis / etiology,  therapy*
Chemical
Reg. No./Substance:
0/Viscosupplements; 9004-61-9/Hyaluronic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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