- Original article
- Open Access
Comparison between functional outcomes in patients with unilateral vocal fold paralysis undergoing injection laryngoplasty under general anesthesia versus local anesthesia
The Egyptian Journal of Otolaryngology volume 35, pages 92–102 (2019)
Injection laryngoplasty (IL) continues to evolve, as new techniques, approaches, and injection materials are continuously being developed. Although it was performed under general anesthesia in the operating room, IL is now increasingly being performed in an office-based setting.
The aim of this study was to compare functional voice outcomes in patients with unilateral vocal fold paralysis undergoing injection laryngoplasty local versus general anesthesia.
Patients and Methods
A prospective interventional study was done to compare functional outcomes and patient satisfaction between group A (15 patients) with unilateral vocal fold paralysis undergoing injection laryngoplasty under local anesthesia, versus group B (15 patients) with unilateral vocal fold paralysis undergoing injection laryngoplasty under general anesthesia, by analyzing total Arabic Voice Handicap Index (VHI) scores and subscale scores preoperatively and post operatively.
All results obtained in this study showed that there was no significant difference for the functional outcomes and patient satisfaction obtained for both groups under study.
In conclusion, IL under local anesthesia gives similar results as general anesthesia regarding functional outcomes and patient satisfaction of voice quality by themselves as well as by using the voice handicap index.
Deary IJ, Webb A, MacKenzie K, Wilson JA, Carding PN. Short, self-report voice symptom scales: psychometric characteristics of the voice handicap index-10 and the vocal performance questionnaire. Otolaryngol Head Neck Surg 2004; 31:232–235.
Carrol T, Rosen CA. Long-term results of calcium hydroxylapetite (CAHA) vocal fold injection for glottal incompetence. Las Vegas, NV, USA: Combined Otolaryngology Spring Meeting, ALA section; 2010.
McFarlane SC, Watterson TL, von Berg S. Behavioral intervention in the presence of unilateral vocal fold paralysis: indications, diagnosis, techniques, and interpretation. Phonoscope 1999; 2:203–215.
Wilson JA, Webb A, Carding PN, Steen IN, Mackenzie K, Deary IJ. Voice symptom scale and the voice handicap index (VHI): a comparison of structure and content. Clin Otolaryngol 2004; 29:169–174.
Jacobson BH, Jonson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, et al. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997; 6:66–70.
Shen T, Damrose EJ, Morzaria S. A meta-analysis of voice outcome comparing calcium hydroxylapatite injection laryngoplasty to silicone thyroplasty. Otolaryngol Head Neck Surg 2013; 148:197–208.
Mallur PS, Rosen CA. Vocal fold injection: review of indications, techniques, and materials for augmentation. Clin Exp Otorhinolaryngol 2010; 3:177–182.
Bove MJ, Jabbour N, Krishna P, Flaherty K, Saul M, Wunar R, et al. Operating room versus office-based injection laryngoplasty: a comparative analysis of reimbursement. Laryngoscope 2007; 117:226–230.
Sulica L, Blitzer A, Lovelace RE, Kaufmann P. Vocal fold paresis of Charcot-Marie-Tooth disease. Ann Otol Rhinol Laryngol 2001; 110:1072–1076.
Malki KH, Mesallam TA, Farahat M, Bukhari M, Murry T. Validation and cultural modification of Arabic voice handicap index. Eur Arch Otorhinolaryngol 2010; 267:1743–1751.
Myssiorek D. Recurrent laryngeal nerve paralysis: anatomy and etiology. Otolaryngol Clin North Am 2004; 37:25–44.
Havas T, Lowinger D, Priestley J. Unilateral vocal fold paralysis: causes, options and outcomes. Aust N Z J Surg 1999; 69:509–513.
Mehlum CS, Faber CE, Grontved AM. Vocal fold palsy-etiology and outcome. Ugeskr Laeger 2009; 171:109–112.
Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull 2011; 99:39–51.
Benninger MS, Ahuja AS, Gardner G, et al. Assessing outcomes for dysphonic patients. J Voice 1998; 12:540–550.
Dejonckere PH, Bradley P, Clemente P, Cornut G, Crevier-Buchmann L, Friedrich G, et al. A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques: guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS). Eur Arch Otorhinolaryngol 2001; 258:77–82.
Mathison CC, Villari CR, Klein AM, Johns MM. Comparison of outcomes and complications between awake and asleep injection laryngoplasty: a case-control study. Laryngoscope 2009; 119:1417–1423.
Nerurkar NK, Kirtane MV, Bhattacharyya AK. Special considerations for the professional voice users. Laryngol Otorhinolaryngol Head Neck Surg 2014; 36:324.
Rosen CA, Simpson CB. Per oral vocal cord augmentation in the clinic setting. operative techniques in laryngology. Heidelberg, Germany: Springer; 2008. 209–213.
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
About this article
Cite this article
El-Badrawy, A.R., El-Hoshy, H.M., Sheikhany, A.R. et al. Comparison between functional outcomes in patients with unilateral vocal fold paralysis undergoing injection laryngoplasty under general anesthesia versus local anesthesia. Egypt J Otolaryngol 35, 92–102 (2019). https://doi.org/10.4103/ejo.ejo_111_18
- functional outcomes
- injection laryngoplasty
- unilateral vocal fold paralysis
- voice handicap index