Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-17T07:23:03.518Z Has data issue: false hasContentIssue false
  • English
  • Français

A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience

Published online by Cambridge University Press:  06 February 2017

D Chandran ,
C Woods ,
S Ullah ,
E Ooi  and
T Athanasiadis
D Chandran
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia
C Woods
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia
S Ullah
Affiliation:
Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Adelaide, Australia
E Ooi
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia
T Athanasiadis*
Affiliation:
Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, Flinders University and Flinders Medical Centre, Adelaide, Australia Adelaide Voice Specialists, Australia
*
Address for correspondence: Dr Theodore Athanasiadis, Flinders ENT, Department of Surgery, Flinders University and Flinders Medical Centre, Bedford Park, Adelaide, SA 5042, Australia Fax: +61 8 8204 7524 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia.

Methods:

A retrospective review was conducted of patients who underwent injection laryngoplasty performed by a single laryngologist in a tertiary Australian laryngology centre, between February 2013 and December 2014. Patient demographics, anaesthetic modality and complications were recorded. Voice Handicap Index 10 and the Grade, Breathiness, Roughness, Asthenia, Strain scale were evaluated.

Results:

Thirty-four laryngoplasties were performed under general anaesthesia and 41 under local anaesthesia, with mean patient ages of 59.5 and 68.8 years, respectively. Voice Handicap Index 10 scores were significantly improved post-injection (p < 0.001), with no significant difference between general anaesthesia and local anaesthesia (p > 0.05). All aspects of the Grade, Breathiness, Roughness, Asthenia, Strain scale showed significant improvement post-injection, except asthenia. There were seven (9.3 per cent) minor complications (five in the general anaesthesia group, two in the local anaesthesia group), all managed conservatively.

Conclusion:

Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended.

Keywords

LaryngoplastyVocal CordsDysphoniaRestylaneComplicationsVocal Cord Paralysis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Supplement S1 , January 2017 , pp. S41 - S46
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented orally at the 65th Australian Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 4–7 March 2015, Sydney, Australia.

References

1 Brünning, W. About a new treatment option for recurrent nerve paralysis [in German]. Verh Dtsch Laryg 1911;18:23 Google Scholar
2 Courey, MS. Injection laryngoplasty. Otolaryngol Clin North Am 2004;37:121–38Google Scholar
3 Dedo, HH, Urrea, RD, Lawson, L. Intracordal injection of Teflon in the treatment of 135 patients with dysphonia. Ann Otol Rhinol Laryngol 1973;82:661–7Google Scholar
4 Ward, PH, Hanson, DG, Abemayor, E. Transcutaneous Teflon injection of the paralyzed vocal cord: a new technique. Laryngoscope 1985;95:644–9CrossRefGoogle ScholarPubMed
5 Ellis, JC, McCaffrey, TV, Desanto, LW, Reiman, HV. Migration of Teflon after vocal cord injection. Otolaryngol Head Neck Surg 1987;96:63–6Google Scholar
6 Nakayama, M, Ford, CN, Bless, DM. Teflon vocal fold augmentation: failures and management in 28 cases. Otolaryngol Head Neck Surg 1993;109:493–8Google Scholar
7 Dedo, HH, Carlsöö, B. Histologic evaluation of Teflon granulomas of human vocal cords: a light and electron microscopic study. Acta Otolaryngol 1982;93:475–84Google Scholar
8 Bové, MJ, Jabbour, N, Krishna, P, Flaherty, K, Saul, M, Wunar, R et al. Operating room versus office-based injection laryngoplasty: a comparative analysis of reimbursement. Laryngoscope 2007;117:226–30Google Scholar
9 Sulica, L, Rosen, CA, Postma, GN, Simpson, B, Amin, M, Courey, M et al. Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications. Laryngoscope 2010;120:319–25Google Scholar
10 Mathison, CC, Villari, CR, Klein, AM, Johns, MM 3rd. Comparison of outcomes and complications between awake and asleep injection laryngoplasty: a case-control study. Laryngoscope 2009;119:1417–23CrossRefGoogle ScholarPubMed
11 Jacobson, BH, Johnson, A, Grywalski, C, Silbergleit, A, Jacobson, G, Benninger, MS et al. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:66–70 Google Scholar
12 Hirano, M. Clinical Examination of Voice. New York: Springer-Verlag, 1981 Google Scholar
13 Birkent, H, Sardesai, M, Hu, A, Merati, AL. Prospective study of voice outcomes and patient tolerance of in-office percutaneous injection laryngoplasty. Laryngoscope 2013;123:1759–62CrossRefGoogle ScholarPubMed
14 Portone, CR, Hapner, ER, McGregor, L, Otto, K, Johns, MM 3rd. Correlation of the Voice Handicap Index (VHI) and the Voice-Related Quality Of Life Measure (V-RQOL). J Voice 2007;21:723–7Google Scholar
15 Andrade Filho, PA, Carrau, RL, Buckmire, RA. Safety and cost-effectiveness of intra-office flexible videolaryngoscopy with transoral vocal fold injection in dysphagic patients. Am J Otolaryngol 2006;27:319–22Google Scholar
16 Damrose, EJ. Percutaneous injection laryngoplasty in the management of acute vocal fold paralysis. Laryngoscope 2010;120:1582–90Google Scholar
17 Carroll, TL, Rosen, CA. Trial vocal fold injection. J Voice 2010;24:494–8Google Scholar
18 Francis, DO, Dang, JH, Fritz, MA, Garrett, CG. Antiplatelet and anticoagulation therapy in microlaryngeal surgery. Laryngoscope 2014;124:928–34Google Scholar
19 Luu, Q, Tsai, V, Mangunta, V, Berke, GS, Chhetri, DK. Safety of percutaneous injection of bovine dermal crosslinked collagen for glottic insufficiency. Otolaryngol Head Neck Surg 2007;136:445–9Google Scholar
20 Mallur, PS, Rosen, CA. Vocal fold injection: review of indications, techniques, and materials for augmentation. Clin Exp Otorhinolaryngol 2010;3:177–82Google Scholar
21 Hertegård, S, Hallén, L, Laurent, C, Lindström, E, Olofsson, K, Testad, P et al. Cross-linked hyaluronan used as augmentation substance for treatment of glottal insufficiency: safety aspects and vocal fold function. Laryngoscope 2002;112:2211–19CrossRefGoogle ScholarPubMed
22 Molteni, G, Bergamini, G, Ricci-Maccarini, A, Marchese, C, Ghidini, A, Alicandri-Ciufelli, M et al. Auto-crosslinked hyaluronan gel injections in phonosurgery. Otolaryngol Head Neck Surg 2010;142:547–53Google Scholar
23 Rosen, CA, Gartner-Schmidt, J, Casiano, R, Anderson, TD, Johnson, F, Reussner, L et al. Vocal fold augmentation with calcium hydroxylapatite (CaHA). Otolaryngol Head Neck Surg 2007;136:198–204 Google Scholar
24 Carroll, TL, Rosen, CA. Long-term results of calcium hydroxylapatite for vocal fold augmentation. Laryngoscope 2011;121:313–19Google Scholar
25 Hughes, RG, Morrison, M. Vocal cord medialization by transcutaneous injection of calcium hydroxylapatite. J Voice 2005;19:674–8Google Scholar