Author(s)
Douglas M. Kempthorne, BS
Hans C. Baertsch, BA
Neel K. Bhatt, MD
John Paul Giliberto, MD
Affiliation(s)
University of Washington School of Medicine; Department of Otolaryngology - Head and Neck Surgery, University of Washington Medical Center
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to recognize the effects on swallowing function following bilateral injection laryngoplasty in patients with age related vocal atrophy who are primarily treated for dysphonia.
Objectives: Bilateral vocal fold injection laryngoplasty is sometimes performed to treat patients with age related vocal atrophy (ARVA). However, improvements in swallow after bilateral injection laryngoplasty for ARVA have not been well described. The purpose of this study was to review changes in swallow function after bilateral injection laryngoplasty in patients with ARVA.
Study Design: Retrospective cohort.
Methods: We reviewed patients with ARVA who received in-office bilateral injection laryngoplasty (n=21). Exclusion criteria: vocal fold scar, laryngeal cancer, vocal atrophy following neurodegenerative disease, prior laryngeal surgery including injection laryngoplasty, history of larynx radiation, and intubation in last 3 months. Improvement in voice and swallow were measured pre- and post-injection using the Eating Assessment Tool-10 (EAT-10) and Voice Handicap Index-10 (VHI-10). Pre- and post-injection stroboscopy was reviewed to analyze the improvement in bowing index (BI).
Results: Average followup was 2.57 (SD=1.51) months. The mean EATGÇô10 pre- and post-injection was 5.1 and 3.3, respectively (p=0.15). The mean VHI-10 pre- and post-injection was 20.9 and 21.2, respectively (p=0.85). The mean decrease in the BI was 2.7 (95% CI:0.3-5.1, n=11).
Conclusions: Bilateral injection laryngoplasty is sometimes performed in patients with ARVA; however, improvements in swallow function have not been well studied. This study suggests that bilateral injection laryngoplasty may provide modest improvement in swallowing among those seeking treatment for dysphonia and vocal atrophy, although this improvement was not statistically significant in this study. Future prospective studies may help to identify which factors in patients with ARVA predict benefit from injection laryngoplasty for both voice and swallowing complaints.