To compare the voice outcome of calcium hydroxylapatite (CaHA) injection laryngoplasty (IL) vs silicone medialization thyroplasty (MT) in the treatment of unilateral vocal fold paralysis (UVFP).
Data Sources
Systematic review of English literature from MEDLINE, Google Scholar, Web of Science, Scopus, and the Cochrane library from January 1, 1980, to December 31, 2010.
Review Methods
Included studies reporting voice-related quality of life (Voice Handicap Inventory [VHI]) following IL with CaHA or MT with silicone. The primary outcome measure was the improvement in VHI. The secondary outcome was improvement in maximum phonatory time (MPT).
Results
Of the 742 abstracts screened for relevancy, 24 studies qualified for analysis. The mean (SD) VHI scores were 72.22 (11.06) before MT and 34.02 (6.48) after MT. The mean (SD) VHI scores were 68.36 (6.88) before IL and 32.24 (7.33) after IL. The paired difference mean of VHI improvement was 38.20 (95% confidence interval [CI], 17.05-59.32; P = .007) for MT and 36.11 (95% CI, 29.65-42.57; P = .001) for IL. The mean (SD) MPT scores were 7.40 (3.14) before IL and 13.00 (1.75) after IL. The mean (SD) MPT scores were 6.16 (1.90) before MT and 12.40 (2.72) after MT. The paired difference mean of MPT improvement was 6.23 (95% CI, 4.74-7.73; P < .001) for MT and 5.60 (95% CI, 2.95-8.25; P = .006) for IL.
Conclusion
Injection laryngoplasty with CaHA and MT with silicone appear to achieve comparable voice improvement within 1 year, but a definitive conclusion is limited by a lack of standardized outcome measures.
O’LearyMAGrilloneGA. Injection laryngoplasty. Otolaryngol Clin North Am. 2006;39:43-54.
2.
KwonTKBuckmireR. Injection laryngoplasty for management of unilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg. 2004;12:538-542.
3.
CoureyMS. Injection laryngoplasty. Otolaryngol Clin North Am. 2004;37:121-138.
4.
HoffmanMRWittREChapinWJMcCullochTMJiangJJ. Multiparameter comparison of injection laryngoplasty, medialization laryngoplasty, and arytenoid adduction in an excised larynx model. Laryngoscope. 2010;120:769-776.
5.
FriedrichG. Titanium vocal fold medializing implant: introducing a novel implant system for external vocal fold medialization. Ann Otol Rhinol Laryngol. 1999;108:79-86.
6.
MorganJEZraickRIGriffinAWBowenTLJohnsonFL. Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis. Laryngoscope. 2007;117:2068-2074.
7.
LeeSWSonYIKimCHLeeJYKimSCKohYW. Voice outcomes of polyacrylamide hydrogel injection laryngoplasty. Laryngoscope. 2007;117:1871-1875.
8.
LiberatiAAltmanDGTetzlaffJ. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1-e34.
9.
MoherDLiberatiATetzlaffJAltmanDG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62:1006-1012.
10.
SwartzMK. The PRISMA statement: a guideline for systematic reviews and meta-analyses. J Pediatr Health Care. 2011;25:1-2.
11.
VinsonKNZraickRIRaglandFJ. Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis: follow-up at six months. Laryngoscope. 2010;120:1802-1807.
12.
van ArdenneNVanderwegenJVan NuffelenGDe BodtMVan de HeyningP. Medialization thyroplasty: vocal outcome of silicone and titanium implant. Eur Arch Otorhinolaryngol. 2010;268:101-107.
13.
KwonTKAnSYAhnJCKimKHSungMW. Calcium hydroxylapatite injection laryngoplasty for the treatment of presbylaryngis: long-term results. Laryngoscope. 2010;120:326-329.
14.
SuehiroAHiranoSKishimotoYTanakaSFordCN. Comparative study of vocal outcomes with silicone versus Gore-Tex thyroplasty. Ann Otol Rhinol Laryngol. 2009;118:405-408.
15.
ShiotaniAOkuboKSaitoK. Injection laryngoplasty with calcium phosphate cement. Otolaryngol Head Neck Surg. 2009;140:816-821.
GillespieMBDozierTSDayTAMartin-HarrisBNguyenSA. Effectiveness of calcium hydroxylapatite paste in vocal rehabilitation. Ann Otol Rhinol Laryngol. 2009;118:546-551.
18.
ReesCJMouadebDABelafskyPC. Thyrohyoid vocal fold augmentation with calcium hydroxyapatite. Otolaryngol Head Neck Surg. 2008;138:743-746.
19.
ChrobokVPellantASramF. Medialization thyroplasty with a customized silicone implant: clinical experience. Folia Phoniatr Logop. 2008;60:91-96.
20.
RosenCAGartner-SchmidtJCasianoR. Vocal fold augmentation with calcium hydroxylapatite (CaHA). Otolaryngol Head Neck Surg. 2007;136:198-204.
21.
DworkinJPShahAGStachlerRJMelecaRJ. Medialization thyroplasty versus injection laryngoplasty for unilateral vocal fold paralysis: a comparative analysis of functional outcomes. J Med Speech Lang Pathol. 2006;14:1-11.
22.
AminMR. Thyrohyoid approach for vocal fold augmentation. Ann Otol Rhinol Laryngol. 2006;115:699-702.
23.
UlozaVPribuisieneRSaferisV. Multidimensional assessment of functional outcomes of medialization thyroplasty. Eur Arch Otorhinolaryngol. 2005;262:616-621.
24.
HughesRGMorrisonM. Vocal cord medialization by transcutaneous injection of calcium hydroxylapatite. J Voice. 2005;19:674-678.
RajAGirhotraMMeherR. Medialization laryngoplasty—a study of 15 cases. Indian J Otolaryngol Head Neck Surg. 2004;56:283-288.
27.
SridharaSRAshokKGRaghunathanMMannSBS. To study voice quality before and after thyroplasty type 1 in patients with symptomatic unilateral vocal cord paralysis. Am J Otolaryngol. 2003;24(6):361-365.
28.
LundyDSCasianoRRMcClintonMEXueJW. Early results of transcutaneous injection laryngoplasty with micronized acellular dermis versus type-I thyroplasty for glottic incompetence dysphonia due to unilateral vocal fold paralysis. J Voice. 2003;17:589-595.
29.
GliklichREGlovskyRMMontgomeryWW. Validation of a voice outcome survey for unilateral vocal cord paralysis. Otolaryngol Head Neck Surg. 1999;120:153-158.
30.
Abdel-AzizMFel-HakNACardingPN. Thyroplasty for functional rehabilitation of the incompetent larynx. J Laryngol Otol. 1998;112:1172-1175.
31.
MaKHWanYMChoLSCheungPP. Silastic medialization for unilateral vocal fold palsy. Hong Kong Med J. 1997;3:224-230.
32.
LederSBSasakiCT. Long-term changes in vocal quality following Isshiki thyroplasty type I. Laryngoscope. 1994;104:275-277.
33.
LaBlanceGRMavesMD. Acoustic characteristics of post-thyroplasty patients. Otolaryngol Head Neck Surg. 1992;107:558-563.
34.
SasakiCTLederSBPetcuLFriedmanCD. Longitudinal voice quality changes following Isshiki thyroplasty type I: the Yale experience. Laryngoscope. 1990;100:849-852.
35.
ShinJENamSYYooSJKimSY. Analysis of voice and quantitative measurement of glottal gap after thyroplasty type I in the treatment of unilateral vocal paralysis. J Voice. 2002;16:136-142.
36.
MorganJEZraickRIGriffinAWBowenTLJohnsonFL. Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis. Laryngoscope. 2007;117:2068-2074.
37.
IsshikiNTairaTKojimaHShojiK. Recent modifications in thyroplasty type I. Ann Otol Rhinol Laryngol. 1989;98:777-779.
38.
IsshikiNMoritaHOkamuraHHiramotoM. Thyroplasty as a new phonosurgical technique. Acta Otolaryngol. 1974;78:451-457.
39.
McCullochTMHoffmanHTAndrewsBTKarnellMP. Arytenoid adduction combined with Gore-Tex medialization thyroplasty. Laryngoscope. 2000;110:1306-1311.
40.
ChhetriDKJahan-ParwarBHartSDBhutaSMBerkeGS. Injection laryngoplasty with calcium hydroxylapatite gel implant in an in vivo canine model. Ann Otol Rhinol Laryngol. 2004;113:259-264.
41.
MortensenMCarrollLWooP. Arytenoid adduction with medialization laryngoplasty versus injection or medialization laryngoplasty: the role of the arytenoidopexy. Laryngoscope. 2009;119:827-831.
