Summary
Introduction
Vocal fold atrophy and scar can lead to loss of normal superficial lamina propria,
negatively affecting the vibratory function of the vocal fold. These changes can lead
to dysphonia, vocal fatigue, decreased volume, and altered pitch. Treatment options
for these conditions are limited. Platelet-rich plasma (PRP) consists of platelets,
growth factors, and cytokines derived from the patient's own blood and is believed
to activate tissue regeneration. The purpose of this study was to review the technical
aspects of collecting PRP and injecting it into the vocal fold injection – based on
our initial experience with this procedure.
Case
A patient with vocal fold scar was identified and enrolled in an ongoing prospective
clinical trial study of a series of 4 monthly subepithelial vocal fold PRP injections,
which was temporarily halted due to the COVID-19 pandemic. Patient underwent a single
injection of autologous PRP into the left vocal fold. There were no adverse events
during the study period. Subjective improvement in voice was noted at 1 month after
injection with subsequent return to baseline over the next 4 months. Videostroboscopy
performed on postinjection day 1 and day 7 and demonstrated no concerning exam changes.
Compared to the preinjection baseline, the patient-reported voice-handicap index-10
(VHI-10) and voice catastrophization index were similar at 4 months following injection
(20 to 20 and 4 to 3, respectively). Independent perceptual analysis of voice showed
improvement at 4 months postinjection, compared to baseline consensus auditory-perceptual
evaluation of voice 60 to 44.
Conclusions
This preliminary report was part of a prospective trial investigating the use of PRP
to treat vocal fold atrophy and scar. This work highlights the technical considerations
for injecting PRP into the vocal fold. Planned prospective enrollment in this study
will help to validate the safety and efficacy of PRP injections.
Key Words
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Article info
Publication history
Published online: January 11, 2021
Accepted:
December 17,
2020
Footnotes
Site of research: Tina and Rick Caruso Department of Otolaryngology – Head and Neck Surgery, University of Southern California (USC), Los Angeles, CA.
Financial support: None.
Author Statement: The listed authors have no financial disclosures or conflicts of interest. This work is original and has not been previously-published or submitted to another publication.
Identification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
