Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?

Background: Early injection laryngoplasty (EIL) using hyaluronic acid (HA) is an effective treatment for glottic insufficiency in patients with acute unilateral vocal fold paralysis (UVFP). Most patients benefit by showing improvement in voice and quality of life and implied reduced need for permane...

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Autores principales:	Yi-Chieh Lee, Yu-Cheng Pei, Yi-An Lu, Hsiu-Feng Chung, Hsueh-Yu Li, Li-Ang Lee, Tuan-Jen Fang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	hyaluronate injection HA unilateral vocal fold paralysis Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/9c31ea708cbc411cbacf2d554e46d253
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spelling	oai:doaj.org-article:9c31ea708cbc411cbacf2d554e46d2532021-11-25T16:52:14ZLong-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?10.3390/biom111115802218-273Xhttps://doaj.org/article/9c31ea708cbc411cbacf2d554e46d2532021-10-01T00:00:00Zhttps://www.mdpi.com/2218-273X/11/11/1580https://doaj.org/toc/2218-273XBackground: Early injection laryngoplasty (EIL) using hyaluronic acid (HA) is an effective treatment for glottic insufficiency in patients with acute unilateral vocal fold paralysis (UVFP). Most patients benefit by showing improvement in voice and quality of life and implied reduced need for permanent laryngoplasty. However, injected HA might resolve within a short period, so its long-term outcomes and the need for secondary procedures need to be clarified. Methods: Patients who underwent EIL with HA for acute UVFP from January 2015 to December 2018 were included. The factors that may associate with the prognosis including voice performance and laryngeal configuration at presentation, the cause of UVFP, and the type of HA for EIL were analyzed. Results: Ninety-four patients were included for analysis, with a mean follow-up period of 25.1 months (95% CI: 22.8–27.4 months). After primary HA injection, 22 patients (23.4%) underwent secondary procedures (rate: 13.1% per person-year), and most (63.6%) of the events occurred after one year from the first injection. The rate of secondary procedures within the first 12 months was 9.0% (14.1% and 4.3% for low-concentrated HA (LHA) and high-concentrated HA (HHA), respectively). The incidence of the secondary procedures was higher in the LHA group (18.2%) (<i>p</i> = 0.026) than in the HHA group (7.5%). Conclusions: The rate of secondary procedures was lower than the prediction based on the resorption time of HA, a finding that could be partly accounted for by both natural nerve recovery and a long-lasting effect of EIL. EIL with HHA had a lower rate of re-treatment than that with LHA, suggesting a better clinical utility for acute UVFP.Yi-Chieh LeeYu-Cheng PeiYi-An LuHsiu-Feng ChungHsueh-Yu LiLi-Ang LeeTuan-Jen FangMDPI AGarticlehyaluronate injectionHAunilateral vocal fold paralysisMicrobiologyQR1-502ENBiomolecules, Vol 11, Iss 1580, p 1580 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hyaluronate injection HA unilateral vocal fold paralysis Microbiology QR1-502
spellingShingle	hyaluronate injection HA unilateral vocal fold paralysis Microbiology QR1-502 Yi-Chieh Lee Yu-Cheng Pei Yi-An Lu Hsiu-Feng Chung Hsueh-Yu Li Li-Ang Lee Tuan-Jen Fang Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?
description	Background: Early injection laryngoplasty (EIL) using hyaluronic acid (HA) is an effective treatment for glottic insufficiency in patients with acute unilateral vocal fold paralysis (UVFP). Most patients benefit by showing improvement in voice and quality of life and implied reduced need for permanent laryngoplasty. However, injected HA might resolve within a short period, so its long-term outcomes and the need for secondary procedures need to be clarified. Methods: Patients who underwent EIL with HA for acute UVFP from January 2015 to December 2018 were included. The factors that may associate with the prognosis including voice performance and laryngeal configuration at presentation, the cause of UVFP, and the type of HA for EIL were analyzed. Results: Ninety-four patients were included for analysis, with a mean follow-up period of 25.1 months (95% CI: 22.8–27.4 months). After primary HA injection, 22 patients (23.4%) underwent secondary procedures (rate: 13.1% per person-year), and most (63.6%) of the events occurred after one year from the first injection. The rate of secondary procedures within the first 12 months was 9.0% (14.1% and 4.3% for low-concentrated HA (LHA) and high-concentrated HA (HHA), respectively). The incidence of the secondary procedures was higher in the LHA group (18.2%) (<i>p</i> = 0.026) than in the HHA group (7.5%). Conclusions: The rate of secondary procedures was lower than the prediction based on the resorption time of HA, a finding that could be partly accounted for by both natural nerve recovery and a long-lasting effect of EIL. EIL with HHA had a lower rate of re-treatment than that with LHA, suggesting a better clinical utility for acute UVFP.
format	article
author	Yi-Chieh Lee Yu-Cheng Pei Yi-An Lu Hsiu-Feng Chung Hsueh-Yu Li Li-Ang Lee Tuan-Jen Fang
author_facet	Yi-Chieh Lee Yu-Cheng Pei Yi-An Lu Hsiu-Feng Chung Hsueh-Yu Li Li-Ang Lee Tuan-Jen Fang
author_sort	Yi-Chieh Lee
title	Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?
title_short	Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?
title_full	Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?
title_fullStr	Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?
title_full_unstemmed	Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?
title_sort	long-lasting effect after single hyaluronate injection for unilateral vocal fold paralysis: does concentration matter?
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9c31ea708cbc411cbacf2d554e46d253
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Long-Lasting Effect after Single Hyaluronate Injection for Unilateral Vocal Fold Paralysis: Does Concentration Matter?

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