Long-term effects of laryngeal augmentation with calcium hydroxyapatite under local anaesthesia
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Aim: We assessed long-term outcomes of vocal fold augmentation with calcium hydroxylapatyte performed under local anesthesia.
Material and methods: We enrolled 17 patients with glottic insuf ficiency due to unilateral laryngeal paralysis or insuf ficiency of internal laryngeal muscles (10 women, 17 men; mean age, 57.6±17.7 years; median age, 61 years; age range, 32-83 years). All patients underwent laryngeal augmentation under local anesthesia, through the oral cavity, with calcium hydroxylapatite (Radiesse) injected laterally to the vocal folds, unilaterally or bilaterally. We assessed voice quality before laryngeal augmentation and at 3 and 12 months. To that end, we performed videolaryngostroboscopy, perceptual assessment of voice, acoustic analyses, and aerodynamic assessments; moreover, participants completed the Voice-Related Quality of Life (VRQoL) questionnaire.
Results: Af ter 3 months, we observed a statistically significant improvement on the perceptual assessment of voice with regard to the G and A parameters, and good outcomes were also observed at 12 months. On the acoustic analyses, MDVP_Jitt, MDVP_Shim, and MDVP_NHR improved to 2.5, 5, and 0.1, respectively, at 3 months, and to 1.9, 3.6, and 0.1, respectively, at 12 months. MPTa was prolonged to 12.2s and 11.9s at 3 and 12 months, respectively. Voice intensity improved from 67dB(A) before augmentation to 68dB(A) and 71dB(A) at 3 and 12 months, respectively. VRQoL scores improved to 19.5 and 20 at 3 and 12 months, respectively.
Discussion: Laryngeal augmentation with calcium hydroxylapatite performed under local anesthesia is associated with good long-term outcomes.
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