title: Vocal fold augmentation with calcium hydroxylapatite: twelve-month report.
abstract: OBJECTIVE
  To evaluate the long-term effectiveness of calcium hydroxylapatite (CaHA) vocal fold injection for patients with glottal insufficiency.
  
  
  METHODS
  Multicenter, open-label, prospective clinical study of CaHA vocal fold injection.
  
  
  METHODS
  Each patient served as his/her own control. Voice-related outcome measures were collected for pre-injection, 1, 3, 6, and 12 months.
  
  
  RESULTS
  Sixty-three patients were available for evaluation. Fifty-three percent of the injection procedures were done in the office. Fifty-seven percent of patients were diagnosed with unilateral paralysis and 43% with glottal incompetence with mobile vocal folds. Patient satisfaction 12 months after injection showed 67% reporting a significant improvement in voice and 81% reporting at least a moderate improvement in voice. Utilizing the Voice Handicap Index-10, visual analog scale (vocal effort), Consensus Assessment Perceptual Evaluation V (judgments of voice severity), and objective voice measures of glottal closure (maximum phonation time and S:Z ratio), paired t tests showed significant improvements after treatment. A 22% further treatment rate was found at the 12-month time point.
  
  
  CONCLUSIONS
  One-year results in this large cohort of patients with glottal incompetence treated with CaHA vocal fold injection demonstrate that excellent clinical results were achieved.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, USA. RosenCA@upmc.edu
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
authors.forename: Jackie
authors.initials: J
authors.lastname: Gartner-Schmidt
authors.forename: Roy
authors.initials: R
authors.lastname: Casiano
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Anderson
authors.forename: Felicia
authors.initials: F
authors.lastname: Johnson
authors.forename: Marc
authors.initials: M
authors.lastname: Remacle
authors.forename: Robert T
authors.initials: RT
authors.lastname: Sataloff
authors.forename: Jean
authors.initials: J
authors.lastname: Abitbol
authors.forename: Gary
authors.initials: G
authors.lastname: Shaw
authors.forename: Sanford
authors.initials: S
authors.lastname: Archer
authors.forename: Richard I
authors.initials: RI
authors.lastname: Zraick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000627:therapeutic use*; D017886:Durapatite / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D049489:Stroboscopy; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000188:drug therapy*; D014827:Vocal Cords / Q000187:drug effects*
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite