Abstract
Objective
A single injection of basic fibroblast growth factor (bFGF) into the vocal folds of
patients with glottal insufficiency has been shown to be effective for a few years.
However, the long-term therapeutic effect of a single injection of bFGF into the vocal
folds has yet to be demonstrated. In this study, the therapeutic effect of a single
injection of bFGF into the vocal folds was investigated over several years by monitoring
patients for 36 months following this treatment.
Methods
Nineteen patients with glottal insufficiency received injections of bFGF diluted to
20 μg/mL in the superficial layer of the lamina propria of the bilateral vocal folds.
The following parameters were evaluated at preinjection baseline and 6, 12, 18, 24,
and 36 months later, and statistical comparisons were performed. The parameters evaluated
were: the Grade, Rough, Breathy, Asthenic, and Strained (GRBAS) scale score; maximum
phonation time; acoustic analysis; and glottal wave analysis (GWA) and kymograph edge
analysis (KEA) using high-speed digital imaging (HSDI). The amplitude perturbation
quotient (APQ) and period perturbation quotient (PPQ) were measured by acoustic analysis.
The mean minimum glottal area during vocalization and mean minimum distance between
the vocal folds were measured by GWA. The amplitudes of the bilateral vocal folds
were measured by KEA.
Results
Postinjection, the GRBAS scale score decreased from 6 months after injection, and
maximum phonation time was prolonged. The mean minimum glottal area during vocalization
and the mean minimum distance between the vocal folds calculated by GWA of HSDI decreased
significantly after 6 months. These effects persisted until 36 months postinjection.
APQ and PPQ derived from acoustic analysis tended to decrease, but not significantly.
There was no clear change in the amplitudes of the bilateral vocal folds calculated
by KEA of HSDI before and after injection.
Conclusions
These results suggest that the effects of a single injection of bFGF into the vocal
folds persist for 36 months.
Keywords
Abbreviations:
APQ (amplitude perturbation quotient), bFGF (basic fibroblast growth factor), GRBAS (the Grade, Rough, Breathy, Asthenic, and Strained), GWA (glottal wave analysis), HSDI (high-speed digital imaging), KEA (kymograph edge analysis), MPT (maximum phonation time), PPQ (period perturbation quotient), SPL (sound pressure level)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 08, 2021
Accepted:
January 11,
2021
Identification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
