Abstract

SANABRIA-GRECIANO, Lucía et al. Early infiltration in vocal cord paralysis: evolution and predictors. Rev. ORL [online]. 2023, vol.14, n.2, e29825.  Epub Mar 04, 2024. ISSN 2444-7986.  https://dx.doi.org/10.14201/orl.29825.

Introduction and objective: Vocal cord paralysis is a prevalent and disabling pathology. The main objective is to compare the recovery of movility and functionality of vocal cords, as well as the requirement of definitive surgery in two groups of patients: non-infiltrated group (NIG) versus early infiltration group with hyaluronic acid (EIG). Method: Retrospective observational study. To set up the NIG, we sorted the database of 715 videos labeled as “laryngeal paralysis” and selected n=33 patients who met the inclusion criteria of the study. To create the EIG, we selected patients injected with hyaluronic acid in the last 3 years (n=22). In the NIG, the following were analyzed as outcome measures: recovery of mobility and functionality of the cord and the need for thyroplasty. In the EIG, the date of infiltration was also measured. Results: The results of the EIG are significantly better (p=0,001) in terms of vocal cord mobility recovery. A non-significant reduction (p=0.14) was observed in the need for thyroplasty in injected patients. There are significant differences between patients with unilateral paralysis of the NIG vs EIG (p=0.009), while the bilateral groups are not comparable, due to the compromise of the airway suffered by patients with the cord in a medial position. Discussion: Early infiltration with hyaluronic acid provides temporary treatment of the glottic closure defect with a low rate of complications, prolonging the maximum phonation time and improving the vocal movement, which may reduce the need for subsequent treatments. It has been proposed as a treatment that can improve the patient's quality of life. However, it is important to properly select patients, since not all may be candidates. Conclusions: Early infiltration with hyaluronic acid generates a significant improvement in the recovery of vocal cords mobility, supporting the early indication of this therapy. Although a lower need for thyroplasty is observed in GIT, the differences are not significant.

Keywords : Vocal cord paralysis; hyaluronic acid; laryngoplasty; quality of life.

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