title: Early hyaluronate injection improves quality of life but not neural recovery in unilateral vocal fold paralysis: an open-label randomized controlled study.
abstract: OBJECTIVE
  To investigate the neurologic and functional effect of intracordal hyaluronate injections in acute unilateral vocal fold paralysis (UVFP) in a randomized controlled trial.
  
  
  METHODS
  In this open-label, randomized controlled study, 29 patients with UVFP were recruited within 6 months of their first outpatient visit and were randomized to receive either single hyaluronate injection (HI group) or conservative management (CM group). Quantitative laryngeal electromyography, videolaryngostroboscopy, UVFP-related quality of life (Voice Outcomes Survey, VOS), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1, 3 and 6 months post-injection in the HI group, and at baseline and 6 months in the CM group.
  
  
  RESULTS
  Improvements in most quality of life domains and other assessments were comparable between the HI and CM groups; however, the HI group had a greater improvement in the mental health domain of quality of life at the end of follow-up.
  
  
  CONCLUSIONS
  Early hyaluronate injection cannot improve nerve regeneration but can result in long-lasting improvements in patients' psychosocial well-being, thus highlighting the importance of early intervention for patients with UVFP.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan School of Medicine, Chang Gung University, Taoyuan, Taiwan Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Pei
authors.affiliation: School of Medicine, Chang Gung University, Taoyuan, Taiwan Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
authors.forename: Tuan-Jen
authors.initials: TJ
authors.lastname: Fang
authors.affiliation: School of Medicine, Chang Gung University, Taoyuan, Taiwan Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Hsin
authors.affiliation: School of Medicine, Chang Gung University, Taoyuan, Taiwan Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
authors.forename: Hsueh-Yu
authors.initials: HY
authors.lastname: Li
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan School of Medicine, Chang Gung University, Taoyuan, Taiwan Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Alice Mk
authors.initials: AM
authors.lastname: Wong
mesh_terms: D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections; D058753:Laryngoplasty / Q000379:methods; D007828:Laryngoscopy; D007830:Larynx / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009416:Nerve Regeneration / Q000187:drug effects* / Q000502:physiology; D011788:Quality of Life; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage*; D014826:Vocal Cord Paralysis / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D014831:Voice / Q000187:drug effects
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Unilateral vocal fold paralysis; glottal gap; hyaluronate; injection laryngoplasty; laryngeal electromyography; quality of life