Summary
Background
Injectable laryngoplasty with hydroxyapatite and hyaluronic acid is frequently used
for the treatment of glottic incompetence. The effectiveness of these substances is
controversial due to the heterogeneity of studies.
Objectives
To evaluate the effectiveness of the treatment for glottic incompetence using hydroxyapatite
and hyaluronic acid.
Study design
Systematic review and meta-analysis.
Data sources
MEDLINE, PUBMED, LILACS, SCOPUS, EMBASE, Cochrane, clinicaltrials.gov, published and
unpublished trials, Web of Science.
Eligibility criteria
Studies that evaluated vocal fold function before and after 4-6 weeks and 6 months
of hydroxyapatite and hyaluronic acid injection in adults with glottic incompetence.
Exclusion criteria: studies with outcome, follow-up time or type of intervention outside
the predetermined pattern or systematic review and meta-analysis.
Synthesis of methods
Primary outcome - Maximum Phonation Time. Secondary outcomes - Voice Handicap Index
(VHI)-30, Parameters G and B of GRBAS Scale. Outcomes were analyzed for mean differences
with the corresponding 95% CI.
Results
Six hundred forty-four studies identified, 12 included (5 CaHA; 6 HA; 1 HA and CaHA).
After 4-6 weeks the mean difference were: MPT (+5.86), IDV (-39.32), G (-1.14), and
B (-1.46). After 6 months: MPT (+5.97), IDV (-30.13), G (-1.33), and B (-1.33).
Limitations
Studies comparing injectable drugs are small, as well as the number of patients in
each one, making the isolated comparison of substances difficult.
Conclusions and implications
There is an evidence that the injectable substances HA and CaHA are effective in the
treatment of glottic incompetence, however, it is important that more studies are
carried out comparing the two substances.
Key words
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Article info
Publication history
Published online: February 17, 2023
Accepted:
January 17,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
