Voice outcomes of polyacrylamide hydrogel injection laryngoplasty.
OBJECTIVE
Polyacrylamide hydrogel (PAAG, Aquamid) is widely used as permanent facial tissue filler during facial plastic surgery. In this study, we examined the long-term effects and safety aspects of PAAG as a vocal fold augmentation material for patients with permanent unilateral vocal cord paralysis.


METHODS
Prospective clinical trials.


METHODS
PAAG injection laryngoplasty was performed in 34 consecutive patients with permanent unilateral vocal cord paralysis. Percutaneous injection was performed under local anesthesia into the vocalis muscle using disposable 25 gauge long needles. Of the 34 patients, 16 completed acoustic, perceptual, stroboscopic, and subjective evaluations prior to the injection and at 6 and 12 months after the injection.


RESULTS
Acoustic and perceptual parameters (GRBAS [Overall grade of dysphonia, Roughness, Breathiness, Aesthenia, Strain], Maximal phonation time [MPT], jitter, and shimmer) were significantly improved (P < .05) after injection and remained stable over 12 months. The grades of mucosal waves and glottic closure were also significantly improved (P < .01). The voice handicap index (VHI), as well as the visual analogue scale (VAS) of hoarseness and aspiration significantly improved over 12 months. No adverse effects were observed except for a decrease in the mucosal wave of one patient, after injection into a superficial area of the vocal fold.


CONCLUSIONS
Based on the preliminary results of this trial, PAAG appears to be a long-lasting and safe injection material that is suitable for the treatment of glottal insufficiency caused by permanent unilateral vocal cord paralysis.
Lee
Seung Won
SW
Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
Son
Young-Ik
YI
Kim
Chan Hee
CH
Lee
Jae Yong
JY
Kim
Shi Chan
SC
Koh
Yoon Woo
YW
D000180:Acrylic Resins / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013061:Speech Acoustics; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000188:drug therapy* / Q000601:surgery*
D000180:Acrylic Resins; D001672:Biocompatible Materials; C016680:polyacrylamide gels