title: Single injection of basic fibroblast growth factor to treat severe vocal fold lesions and vocal fold paralysis.
abstract: OBJECTIVE
  Severe vocal fold lesions such as vocal fold sulcus, scars, and atrophy induce a communication disorder due to severe hoarseness, but a treatment has not been established. Basic fibroblast growth factor (bFGF) therapies by either four-time repeated local injections or regenerative surgery for vocal fold scar and sulcus have previously been reported, and favorable outcomes have been observed. In this study, we modified bFGF therapy using a single of bFGF injection, which may potentially be used in office procedures.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Five cases of vocal fold sulcus, six cases of scars, seven cases of paralysis, and 17 cases of atrophy were treated by a local injection of bFGF. The injection regimen involved injecting 50 µg of bFGF dissolved in 0.5 mL saline only once into the superficial lamina propria using a 23-gauge injection needle. Two months to 3 months after the injection, phonological outcomes were evaluated.
  
  
  RESULTS
  The maximum phonation time (MPT), mean airflow rate, pitch range, speech fundamental frequency, jitter, and voice handicap index improved significantly after the bFGF injection. Furthermore, improvement in the MPT was significantly greater in patients with (in increasing order) vocal fold atrophy, scar, and paralysis. The improvement in the MPT among all patients was significantly correlated with age; the MPT improved more greatly in younger patients.
  
  
  CONCLUSIONS
  Regenerative treatments by bFGF injection—even a single injection—effectively improve vocal function in vocal fold lesions.
  
  
  METHODS
  4
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.|Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Shimotsuke, Japan.
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kanazawa
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Komazawa
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.|Department of Otolaryngology, Kagawa University, School of Medicine, Miki, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Indo
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.|Department of Otolaryngology-Head and Neck Surgery, Okayama Medical Center, Okayama, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Akagi
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
authors.forename: Yogaku
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.|Department of Otolaryngology-Head and Neck Surgery, Tokyo Medical University, Hachioji Medical Center, Hachioji, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.|Department of Otolaryngology-Head and Neck Surgery, Toho University, Omori Medical Center, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Matsushima
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.|Department of Otorhinolaryngology, Hashima City Hospital, Hashima, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Kunieda
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Misawa
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Shimotsuke, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishino
authors.affiliation: Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy / Q000188:drug therapy; D002921:Cicatrix / Q000188:drug therapy; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D007818:Laryngeal Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014826:Vocal Cord Paralysis / Q000188:drug therapy*; D014827:Vocal Cords / Q000473:pathology; D055815:Young Adult
chemical_list: D016222:Fibroblast Growth Factor 2
keywords: Basic fibroblast growth factor; local anesthesia; regenerative medicine; single injection; vocal fold lesion