title: Effectiveness of calcium hydroxylapatite paste in vocal rehabilitation.
abstract: OBJECTIVE
  We determined the effectiveness of calcium hydroxylapatite (CaHA) paste in vocal rehabilitation.
  
  
  METHODS
  We examined a retrospective case series of 39 adult patients who underwent CaHA paste injection for vocal fold rehabilitation over a 5-year period. The outcomes included the change in the Voice Handicap Index (VHI) score; procedure-related complications; and the need for follow-up voice procedures.
  
  
  RESULTS
  The VHI scores demonstrated overall improvement, with a decrease from the preoperative mean of 61.2 +/- 24.0 to a postoperative mean of 35.9 +/- 26.3 (p = 0.0001) after a mean follow-up time of 17.8 +/- 13.6 months. The procedure was more likely to succeed in patients with paralysis and/or paresis than in patients with glottic soft tissue defects. After injection, the VHI scores worsened in 3 of 7 patients (43%) in the soft tissue defect group, compared to only 2 of 28 (7%) in the paralysis and/or paresis group (p = 0.04). Four of 7 patients with soft tissue defects (57%) required secondary vocal procedures to improve the voice, compared to only 2 of 32 (6%) in the paralysis and/or paresis group (p = 0.006).
  
  
  CONCLUSIONS
  Injection of CaHA paste results in significantly improved vocal scores in the majority of patients. Use of the paste was less satisfactory in patients with soft tissue defects because of poor retention of the paste in the scarred vocal fold remnant.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425-5500, USA.
authors.forename: M Boyd
authors.initials: MB
authors.lastname: Gillespie
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Dozier
authors.forename: Terry A
authors.initials: TA
authors.lastname: Day
authors.forename: Bonnie
authors.initials: B
authors.lastname: Martin-Harris
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use*; D015331:Cohort Studies; D017886:Durapatite / Q000627:therapeutic use*; D055154:Dysphonia / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007267:Injections; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009824:Ointments; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000534:rehabilitation*
chemical_list: D001672:Biocompatible Materials; D009824:Ointments; D017886:Durapatite