Author(s)
Zaroug Jaleel, MD
Hamzah A. Al-Awadi, MAMS
Yasmin Sabry, SLP
Mohamed A. Aboueisha, MD
Rachel Jones, MD
Neel K. Bhatt, MD
Affiliation(s)
University of Washington - Seattle;
Abstract:
Introduction: Unilateral vocal fold immobility (UVFI) affects voice and swallowing. Injection laryngoplasty (IL) is frequently performed to improve glottic closure. In aged individuals with UVFI, vocal folds can also show signs of atrophy, further contributing to the glottic incompetence. The purpose of this was study was to determine whether age affects the treatment response to IL.
Methods: Adult patients with UVFI who underwent unilateral IL were included in this study. Patients were excluded if they <18 years, had bilateral VFI and/or underwent bilateral IL. Primary outcome measures were Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), Voice Handicap Index-10 (VHI-10), Bowing index (BI) and injection volume.
Results: 42 patients were included. Patients with UVFI experienced significant improvement in CAPE-V, VHI-10, and BI following IL with a mean difference(MD) of 11.81(95%CI:6.38,17.23,p<0.001), 3.7(95%CI:0.93,6.46, p=0.01) and 3.53(95%CI:2.78,4.2,p<0.001) respectively. Age > 65 was associated with worse scores in pre and post-operative CAPE-V with mean ± SD of (56.4±20.7 vs 38.5±16.8, p<0.01) and (39.7±13.3 vs 25.7±17.3, p<0.01) respectively. There was no significant relationship between age and absolute treatment response in CAPE-V, BI and VHI-10. There was no significant relationship between age and injection volume.
Conclusion: Age did not affect absolute treatment response following IL in patients with UVFI. However, patient age was associated with worse pre-injection and post-injection voice measures. This study suggests age is an important factor that negatively impacts baseline dysphonia severity, but absolute treatment response following IL appears similar between aged and non-aged individuals.