- Country: Canada
- Official Title: Clinical Associate Professor
- Department: Department of Surgery, Division of Otolaryngology – Head & Neck Surgery
- Institute: University of British Columbia
- E-Mail: amanda.hu@vch.ca
Speech Title
Laryngeal Electromyography guided Vocal Fold Injections-Canada Experiences
喉肌電圖導引聲帶注射-加拿大經驗
Objectives: To assess voice outcomes using the novel technique of in-office laryngeal electromyography-guided vocal fold injections (LEVFI) with hyaluronic acid to treat glottal insufficiency.
Methods: Retrospective review of patients who received LEVFI from August 2017 to December 2018. Three and six-month voice outcomes were assessed. Outcomes included voice handicap index-10(VHI-10), maximum phonation time (MPT), perceptual analysis of voice (GRBAS), fundamental frequency, and stroboscopy.
Results: Of the 121 eligible patients (55.4% male, age 63.7 years), 94(77.7%) had complete 3-month data and 59(48.8%) had complete 6-month data. VHI-10 was significantly improved from 25.7±7.5 to 20.9±10.9 at 3-months (P<.001) and 19.1±11.5 at 6-months (P<.001). MPT improved from 6.2±5.4 to 9.4±7.1 seconds at 3-months (P<.001) and 11.3±8.2 seconds at 6-months (P<.001). GRBAS was improved in 74.8% ([65.2, 82.8] 95% CI) at 3-months and 80.8% ([69.9, 89.1]) 95% CI) at 6-months. Stroboscopy showed a glottic gap improvement in 74.8% ([65.8, 82.4] 95% CI) at 3-months and 80.3% ([65.9, 88.5] 95% CI) at 6-months. Fundamental frequency was unchanged. Multivariate analysis reported that no factors were associated with better outcomes. Overall, 177/181 (97.8%) injections were completed with no complications.
Conclusion: LEVFI is an effective, novel technique with improved voice outcomes, high completion rate, and no significant complications.