Injection laryngoplasty with calcium phosphate cement.
OBJECTIVE
To assess the feasibility of injection laryngoplasty with calcium phosphate cement (CPC), which is an injectable paste, self-hardening, and which recrystallizes to calcium hydroxylapatite after injection.


METHODS
A case series with planned data collection.


METHODS
Fifty-six patients with unilateral vocal fold paralysis, who received injection laryngoplasty with CPC between August 2003 and August 2007 with a minimum follow-up period of six months, were enrolled in this study. Volumetric and migration analysis for injected CPC were performed using CT after surgery. Vocal function was also assessed by GRBAS subjective voice assessment scale and maximum phonation time (MPT), acoustic analysis including period perturbation quotient (PPQ), amplitude perturbation period (APQ), and noise-to-harmonics ratio (NHR).


RESULTS
No remarkable migration or absorption of injected CPC was observed on CT up to two years after surgery. The average remaining volume of CPC was 87.8% +/- 5.3% two years after injection compared to immediately after injection. Significant improvements in GRBAS scales, MPT, PPQ, APQ, and NHR were observed postoperatively. No adverse effects were observed.


CONCLUSIONS
Our clinical experience revealed that CPC was safe, nonabsorbable, and effective. Injection laryngoplasty with CPC may be a useful option in the treatment of glottic insufficiency.
Shiotani
Akihiro
A
Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan. ashiotan@ndmc.ac.jp
Okubo
Keisuke
K
Saito
Koichiro
K
Fujimine
Takekatsu
T
Tomifuji
Masayuki
M
Ikeda
Asako
A
Araki
Koji
K
Momoshima
Suketaka
S
D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000008:administration & dosage*; D002130:Calcium Phosphates / Q000008:administration & dosage*; D003460:Crystallization; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures; D010699:Phonation; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality
D001672:Biocompatible Materials; D002130:Calcium Phosphates