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Early hyaluronate injection improves quality of life but not neural recovery in unilateral vocal fold paralysis: An open-label randomized controlled study

Article type: Research Article

Authors: Pei, Yu-Cheng; ; | Fang, Tuan-Jen; | Hsin, Li-Jen; | Li, Hsueh-Yu; | Wong, Alice MK; ;

Affiliations: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan | School of Medicine, Chang Gung University, Taoyuan, Taiwan | Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan | Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan

Note: [] Equal contribution as the first author.

Note: [] Corresponding author: Tuan-Jen Fang, MD, FICS, Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, 5 Fushing St., Taoyuan 333, Taiwan. Tel.: +886 33281200/Ext. 3971; Fax: +886 33979361; E-mail: fang3109@adm.cgmh.org.tw Equal contribution as the first author.

Keywords: Unilateral vocal fold paralysis, hyaluronate, injection laryngoplasty, glottal gap, quality of life, laryngeal electromyography

DOI: 10.3233/RNN-140439

Journal: Restorative Neurology and Neuroscience, vol. 33, no. 2, pp. 121-130, 2015

Published: 2015
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Abstract

Purpose: To investigate the neurologic and functional effect of intracordal hyaluronate injections in acute unilateral vocal fold paralysis (UVFP) in a randomized controlled trial. Methods: In this open-label, randomized controlled study, 29 patients with UVFP were recruited within 6 months of their first outpatient visit and were randomized to receive either single hyaluronate injection (HI group) or conservative management (CM group). Quantitative laryngeal electromyography, videolaryngostroboscopy, UVFP-related quality of life (Voice Outcomes Survey, VOS), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1, 3 and 6 months post-injection in the HI group, and at baseline and 6 months in the CM group. Results: Improvements in most quality of life domains and other assessments were comparable between the HI and CM groups; however, the HI group had a greater improvement in the mental health domain of quality of life at the end of follow-up. Conclusions: Early hyaluronate injection cannot improve nerve regeneration but can result in long-lasting improvements in patients' psychosocial well-being, thus highlighting the importance of early intervention for patients with UVFP.

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