title: Percutaneous laryngeal collagen augmentation for treatment of parkinsonian hypophonia.
abstract: OBJECTIVE
  Our goal was to determine whether percutaneous laryngeal collagen augmentation improves hypophonia in parkinsonian patients.
  
  
  METHODS
  A retrospective review of 18 patients was performed. Patients and/or caretakers were called on the telephone and asked about their response to the procedure, if any. Videostroboscopic examinations for all patients were reviewed.
  
  
  RESULTS
  Of 18 patients, 11 (61%) reported improvement in their hypophonia for a period of at least 2 months. Five of 7 patients without improvement were relatively aphonic both before and after the procedure. Five of 7 patients without improvement had severe dysphagia, which in 3 necessitated gastrostomy tube placement. Four of 7 patients without improvement were not ambulatory at the time of the procedure.
  
  
  CONCLUSIONS
  Percutaneous laryngeal collagen augmentation is an effective treatment for parkinsonian hypophonia in a majority of patients. Patients with advanced neurologic disease with aphonia, difficulty with speech initiation, dysphagia, or ambulatory difficulty are less likely to respond to this procedure and should be so informed.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA. sookim25@hotmail.com
authors.forename: Soo H
authors.initials: SH
authors.lastname: Kim
authors.forename: James J
authors.initials: JJ
authors.lastname: Kearney
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Atkins
mesh_terms: D000368:Aged; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014832:Voice Disorders / Q000188:drug therapy* / Q000209:etiology
chemical_list: D003094:Collagen