Objective: To investigate the treatment outcomes and prognostic factors of injection laryngoplasty (IL) using cross-linked porcine collagen (PC) and hyaluronic acid (HA) in unilateral vocal fold paralysis (UVFP).
Study design: Case series with chart review.
Setting: A tertiary teaching hospital.
Subjects and methods: This study reviewed 60 consecutive patients with UVFP who underwent IL with PC (n = 33) or HA (n = 27). Objective evaluations included maximal phonation time (MPT) and 10-item voice handicap index (VHI-10). Kaplan-Meier method was applied to evaluate the subjective treatment outcomes according to the patients' self-assessment of symptom recurrence via chart review for the follow-up period of 15 months. Log-rank tests were applied to evaluate the association between clinical factors and subjective treatment outcomes.
Results: Objective outcome measurements revealed significantly improved MPT and VHI-10 at 1, 3, and 6 months posttreatment, with nonsignificant differences between the PC and HA groups. Subjective treatment outcomes also revealed a nonsignificant difference between the 2 groups. The median symptom-free durations were 10.9 and 14.4 months for the PC and HA groups, respectively. Subsequent analyses failed to identify prognostic significance of sex, time to treatment, etiology, side, injection approaches, and the presence of aspiration. No significant adverse effects occurred during the follow-up period.
Conclusion: This study demonstrated comparable subjective and objective improvements following IL using PC or HA in patients with UVFP. No significant prognostic factor of IL was discovered in the present research. Porcine collagen and HA as medium duration materials might play a role in the future of IL.
Keywords: augmentation; hyaluronan; larynx; medialization; vocal fold.