Summary
Objective
Vocal fold injection augmentation (VFIA) is employed diagnostically for patients with
subtle glottic insufficiency. Its use in patients with both vocal fold atrophy and
benign essential voice tremor (EVT) has been reported but not after durable augmentation.
This study intends to evaluate the success of durable VFIA using either autologous
fat or calcium hydroxylapatite in patients with both vocal fold atrophy and comorbid
EVT.
Methods/Design
Retrospective review. Subjects included demonstrated subtle glottic insufficiency
from true vocal fold atrophy and comorbid EVT with no other vocal fold pathology.
Voice Handicap Index (VHI-10), aerodynamic data including subglottic pressure and
airflow, and the tremor scoring scale were evaluated before diagnostic VFIA with carboxymethylcellulose
and after durable VFIA with calcium hydroxylapatite or autologous fat.
Results
Seven patients met inclusion criteria. Six subjects went on to durable VFIA. Three
of six demonstrated meaningful improvement in the VHI-10 score. Subglottic pressure
improved significantly in those subjects with meaningful VHI-10 improvement compared
to those that did not. The tremor did not resolve completely in any subject, but patient
satisfaction and function was improved in four of the six.
Conclusions
VFIA for EVT in the setting of true vocal fold atrophy appears to offer benefit and
may be an alternative treatment pathway for EVT patients. More than half of the subjects
who underwent durable VFIA after successful diagnostic VFIA reported improvement in
their communication despite inconsistent objective outcomes. Subglottic pressure improved
significantly in half of the subjects who also reported a substantive improvement
in their VHI-10.
Level of Evidence
Key Words
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Article info
Publication history
Published online: November 29, 2018
Accepted:
November 5,
2018
Footnotes
Funding: None.
Conflicts of Interest: None.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
