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Kise N, Hirakawa H, Aniya S, Ooshiro T, Kondo S, Tomoda A, Oyakawa Y, Kiyuna A, Suzuki M. Utility of Ultrahigh-Resolution Computed Tomography for Laryngeal Reconstructive Surgery. Laryngoscope 2024; 134:4667-4673. [PMID: 38895821 DOI: 10.1002/lary.31577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE Unilateral vocal fold paralysis (UVFP) presents as incomplete glottal closure and leads to breathy hoarseness. Various treatments, including laryngeal framework surgery (type 1 thyroplasty [TP1] and arytenoid adduction [AA]), have been devised to correct this condition. Ultrahigh-resolution computed tomography (U-HRCT) allows detailed three-dimensional imaging of the larynx, which aids our understanding of vocal fold motion disorders. This study assessed whether U-HRCT is beneficial for correct diagnosis and surgical planning. METHODS The participants were 26 UVFP patients who underwent laryngeal framework surgery (TP1 and/or AA). U-HRCT was used to measure the vocal fold volume (VFV) and level difference (LD). The need to combine AA with TP1 to obtain satisfactory surgical outcomes was evaluated by U-HRCT and various voice function tests. RESULTS VFV was smaller in paralyzed folds than in unaffected folds. LD correlated strongly with voice parameters and showed high intra-rater and inter-rater reliability. The surgical outcome of the laryngeal framework surgery performed was judged to be excellent for improving voice function. Comparison of LD between the TP1 group and TP1 + AA group indicated that LD is an excellent parameter to determine the need to combine AA with TP1. CONCLUSION These findings underscore the value of preoperative U-HRCT, especially LD, in surgical decision-making and afford insights for optimal phonosurgery and individualized intervention. Patients with LD >1.0 mm may benefit from thyroplasty with AA. LEVEL OF EVIDENCE 3 (case-control study) Laryngoscope, 134:4667-4673, 2024.
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Affiliation(s)
- Norimoto Kise
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hitoshi Hirakawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Soya Aniya
- Department of Radiology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Taiyo Ooshiro
- Department of Radiology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shunsuke Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Atsushi Tomoda
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yoshiki Oyakawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Asanori Kiyuna
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Mikio Suzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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van den Broek EMJM, Heijnen BJ, van der Valk JC, Hendriksma M, Langeveld APM, van Benthem PPG, Sjögren EV. Long-term outcomes of bilateral medialisation thyroplasty in patients with vocal fold atrophy with or without sulcus. J Laryngol Otol 2024; 138:570-575. [PMID: 37781766 PMCID: PMC11063655 DOI: 10.1017/s0022215123001640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/04/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Evaluate long-term voice outcome after bilateral medialisation thyroplasty in glottic insufficiency due to vocal fold atrophy with or without sulcus. METHODS Patients after medialisation thyroplasty for vocal fold atrophy with or without sulcus were identified. Long-term post-operative subjective voice outcomes (> 1 year) using Voice Handicap Index-30, subjective ratings on voice aspects and study-specific questionnaire were compared to pre-operative and shorter-term (1 year) values. RESULTS Thirty-six patients were identified, of which 26 were included (16 atrophy, 10 sulcus) with median follow up of 6.7 years. Mean Voice Handicap Index score at > 1 year (40.0) showed clinically relevant (≥ 15 for groups) and statistically significant improvement compared to pre-operative score (58.1) and remained stable compared to post-operative score (35.7) at one year. Ten patients (56 per cent) reported clinically relevant improvement (≥ 10) after more than five years. CONCLUSION Long-term improvement in subjective voice outcomes is attainable in a significant proportion of patients undergoing bilateral medialisation thyroplasty for atrophy with or without sulcus.
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Affiliation(s)
- Emke MJM van den Broek
- Department of Otorhinolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center, Utrecht, The Netherlands
| | - Bas J Heijnen
- Department of Otorhinolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Jens C van der Valk
- Department of Otorhinolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Martine Hendriksma
- Department of Otorhinolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Antonius PM Langeveld
- Department of Otorhinolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter Paul G van Benthem
- Department of Otorhinolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Elisabeth V Sjögren
- Department of Otorhinolaryngology/Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
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Hasegawa T, Watanabe Y. Effects of intracordal trafermin injection on mutational voice disorder. Am J Otolaryngol 2024; 45:104139. [PMID: 38101138 DOI: 10.1016/j.amjoto.2023.104139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Mutational voice disorder is the inability of the voice to adjust to the changes in the larynx during puberty, resulting in the speaking fundamental frequency failing to decrease. Standard treatments for mutational voice disorder are voice therapy and thyroplasty. However, voice therapy takes time to show its effects, and thyroplasty is highly invasive. Herein, we present a case of mutational voice disorder successfully treated with intracordal trafermin injection. CASE SUMMARY A 31-year-old male patient was diagnosed with mutational voice disorder and offered standard treatment, but he requested a less invasive treatment with early effects. We performed intracordal trafermin injection with his consent. Two months after the procedure, the speaking fundamental frequency decreased from 155.5 Hz to 93.0 Hz, and the voice handicap index decreased from 14 to 2. DISCUSSION This case suggests that intracordal trafermin injection is an effective treatment option for mutational voice disorder. Furthermore, compared with the standard treatment methods, it is less invasive and provides effects shortly with only one injection.
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Affiliation(s)
- Tomohiro Hasegawa
- Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan
| | - Yusuke Watanabe
- Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
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Lee JH, Kang HT, Park KN, Lee SW. Treatment efficacy of 532-nm diode laser glottoplasty in patients with sulcus vocalis: a prospective study. Eur Arch Otorhinolaryngol 2024; 281:295-299. [PMID: 37938373 DOI: 10.1007/s00405-023-08277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE This study prospectively assessed the efficacy and safety of 532-nm diode laser glottoplasty in patients with sulcus vocalis. METHODS A prospective human trial was performed from August 2016 to September 2021. 532-nm diode laser glottoplasty was performed in 30 consecutive patients with sulcus vocalis who suffered from voice problems. Patients underwent acoustic aerodynamic, perceptual, stroboscopic, and Voice Handicap Index-10 (VHI-10) evaluations before and 1, 6, and 12 months after laser glottoplasty. RESULTS Most subjective parameters showed significant improvement (P < 0.05) at 6 months after laser glottoplasty and remained stable at 12 months. Most objective parameters showed significant improvement (P < 0.05) at 12 months after laser glottoplasty. Complications during follow-up included mild vocal fold vibration reduction in 3.3% of patients (1/30) and persistent vocal fold edema in 3.3% of patients (1/30). CONCLUSIONS Statistically significant voice improvement at 12 months after 532-nm diode laser glottoplasty was achieved without serious complications.
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Affiliation(s)
- Jeong Hyun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-Ro, Wonmi-Gu, Bucheon, 14584, Korea
| | - Hyun Tag Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-Ro, Wonmi-Gu, Bucheon, 14584, Korea
| | - Ki-Nam Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-Ro, Wonmi-Gu, Bucheon, 14584, Korea
| | - Seung Won Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-Ro, Wonmi-Gu, Bucheon, 14584, Korea.
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Hamilton NJI, Saccente-Kennedy B, Ambler G. The use of basic fibroblast growth factor to improve vocal function: A systematic review and meta-analysis. Clin Otolaryngol 2023; 48:725-733. [PMID: 37246756 DOI: 10.1111/coa.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/29/2023] [Accepted: 05/01/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examines if intralaryngeal injection of basic fibroblast growth factor 2 (FGF2) can improve voice outcomes in those with vocal disability. DESIGN A Systematic review of original human studies reporting voice outcomes following intra-laryngeal injection of basic fibroblast growth factor 2 in those with vocal dysfunction. Databases searched were Medline (1946-July 2022), Embase (1947-July 2022), Cochrane database and Google Scholar. SETTING Secondary or tertiary care centres that undertook the management of voice pathology Hospital. PARTICIPANTS Inclusion criteria were original human studies reporting voice outcome measurements following intralaryngeal injection of FGF2 to treat vocal fold atrophy, vocal fold scarring, vocal fold sulcus or vocal fold palsy. Articles not written in English, studies that did not include human subjects and studies where voice outcome measures were not recorded before and after FGF2 injection were excluded from the review. MAIN OUTCOME MEASURES The primary outcome measure was maximum phonation time. Secondary outcome measures included acoustic analysis, glottic closure, mucosal wave formation, voice handicap index and GRBAS scale. RESULTS Fourteen articles were included out of a search of 1023 and one article was included from scanning reference lists. All studies had a single arm design without control groups. Conditions treated were vocal fold atrophy (n = 186), vocal cord paralysis (n = 74), vocal fold fibrosis (n = 74) and vocal fold sulcus (n = 56). A meta-analysis of six articles reporting on the use of FGF2 in patients with vocal fold atrophy showed a significant increase of mean maximum phonation time of 5.2 s (95% CI: 3.4-7.0) at 3-6 months following injection. A significant improvement in maximum phonation time, voice handicap index and glottic closure was found following injection in most studies assessed. No major adverse events were reported following injection. CONCLUSIONS To date, intralaryngeal injection of basic FGF2 appears to be safe and it may be able to improve voice outcomes in those with vocal dysfunction, especially vocal fold atrophy. Randomised controlled trials are needed to further evaluate efficacy and support the wider use of this therapy.
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Affiliation(s)
- Nick J I Hamilton
- UCL Division of Surgery and Interventional Sciences, Head & Neck Academic Centre, University College London, London, UK
- Department of Laryngology, Royal National Ear Nose & Throat Hospital, University College London Hospitals NHS Trust, London, UK
| | - Brian Saccente-Kennedy
- Department of Laryngology, Royal National Ear Nose & Throat Hospital, University College London Hospitals NHS Trust, London, UK
| | - Gareth Ambler
- UCL Department of Statistical Science, University College London, London, UK
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Hasegawa T, Kanazawa T, Komazawa D, Konomi U, Hirosaki M, Watanabe Y. One Year Outcomes and Longitudinal Changes in Voice Improvement With Single High Dose Intracordal Trafermin Injections for Age-Related Vocal Fold Atrophy. J Voice 2023:S0892-1997(23)00110-8. [PMID: 37142528 DOI: 10.1016/j.jvoice.2023.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Although intracordal trafermin injection has been performed in the treatment of age-related vocal fold atrophy, the effects of single high dose trafermin injections are unknown. In this study, we examined the 1 year outcomes and longitudinal changes in voice improvement with single high dose intracordal trafermin injections. STUDY DESIGN Retrospective study with approval by our Ethics Committee. METHODS The medical records of 34 patients who underwent single high dose (50ug per side) intracordal trafermin injections under local anesthesia for vocal fold atrophy were retrospectively reviewed at 1 month pre-injection and 1 month, 6 months and 1 year post injection. RESULTS Maximum phonation time (MPT), pitch range (PR), Japanese version of voice handicap index (VHI), grade of GRBAS evaluation, and jitter% improved significantly at 1-year post-injection compared to 1-month pre-injection. MPT and PR improved as early as 1-month post-injection and continued to improve most at 1-year post-injection. VHI showed negative progression from 6-months to 1-year post-injection, during which time the speaking fundamental frequency (SFF) changed to the high pitch in men. CONCLUSIONS Single high dose intracordal trafermin injections can be expected to improve voice in the early post-injection period and to maintain its effect for 1 year. SFF may play a role in worsening VHI in men. LEVEL OF EVIDENCE level 4.
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Affiliation(s)
- Tomohiro Hasegawa
- Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan
| | - Takeharu Kanazawa
- Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, Tochigi, Japan
| | | | - Ujimoto Konomi
- Voice and Dizziness Clinic Futakotamagawa Otolaryngology, Tokyo, Japan
| | - Mayu Hirosaki
- Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan
| | - Yusuke Watanabe
- Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
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Hasegawa T, Fujita R, Komazawa D, Konomi U, Hirosaki M, Watanabe Y. Evaluation of Safety After Intracordal Basic Fibroblast Growth Factor Injection. J Voice 2023:S0892-1997(23)00100-5. [PMID: 37028950 DOI: 10.1016/j.jvoice.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 04/09/2023]
Abstract
OBJECTIVES Although there are many reports of voice improvement with intracordal trafermin (a basic fibroblast growth factor) injections under local anesthesia, few papers have documented the safety of trafermin. Therefore, we aimed to investigate whether trafermin is safer than control drugs (triamcinolone acetonide) early after intracordal injection under local anesthesia. METHODS We conducted a retrospective review from the medical records of patients who underwent intracordal injection with trafermin and triamcinolone acetonide under local anesthesia at our institution. Early postinjective complications were defined as changes in vital signs and chief complaints early after intracordal injection. RESULTS A total of 699 and 297 patients underwent intracordal injection under local anesthesia with trafermin and triamcinolone acetonide, respectively. Of these, 227 and 130 patients had early postinjective complications with trafermin and triamcinolone acetonide, retrospectively. The most common complications occurring with trafermin was increased blood pressure in 39 cases (5.58%): 17 cases (2.43%) of blood pressure increase of ≥20 mm Hg. Other complications included pharyngeal discomfort in 37 (5.29%), lightheadedness in 33 (4.72%), and phlegm discharge in 29 (4.15%). Triamcinolone acetonide caused pharyngeal discomfort in 28 patients (9.43%), phlegm discharge in 17 patients (5.72%), lightheadedness in 12 patients (4.04%), sore throat in 11 patients (3.70%), increased blood pressure in 10 patients (3.37%): 7 cases (2.36%) of blood pressure increase of ≥20 mm Hg, and dizziness in seven patients (2.36%). Statistical analysis of the complications between trafermin and triamcinolone acetonide showed no significant differences. CONCLUSIONS The proportion of early postinjective complications from intracordal injection of trafermin is no significant difference in that of triamcinolone acetonide. The results suggest that the early postinjective complications are not due to the drug action of trafermin, but rather to complications from the intracordal injection procedures. Intracordal trafermin injection may be safe in the short term.
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Affiliation(s)
- Tomohiro Hasegawa
- Tokyo Voice Center, International University of Health and Welfare, Minato, Tokyo, Japan
| | - Retsu Fujita
- Innovation & Research Support Center, International University of Health and Welfare, Minato, Tokyo, Japan
| | | | - Ujimoto Konomi
- Voice and Dizziness Clinic Futakotamagawa Otolaryngology, Setagaya-ku, Tokyo, Japan
| | - Mayu Hirosaki
- Tokyo Voice Center, International University of Health and Welfare, Minato, Tokyo, Japan
| | - Yusuke Watanabe
- Tokyo Voice Center, International University of Health and Welfare, Minato, Tokyo, Japan.
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Hasegawa T, Komazawa D, Konomi U, Hirosaki M, Watanabe Y. Changes in serum basic fibroblast growth factor concentration following intracordal injection. Laryngoscope Investig Otolaryngol 2023; 8:478-487. [PMID: 37090871 PMCID: PMC10116976 DOI: 10.1002/lio2.1022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/15/2022] [Accepted: 02/04/2023] [Indexed: 02/23/2023] Open
Abstract
Objective Although many studies have reported improvements in voice outcomes with intracordal trafermin injection, there is a lack of data documenting its changes in serum basic fibroblast growth factor (bFGF) blood concentration. This study examined whether serum bFGF concentrations change after intracordal trafermin injection. Methods This retrospective study was conducted at Tokyo Voice Center. We investigated serum bFGF concentrations before and after injection in 40 patients who underwent intracordal trafermin injection. There were 26 males and 14 females, with an age ranging from 13 to 88 years (average 53.25 years). They were diagnosed with paralysis (15 patients), atrophy (15 patients), sulcus (8 patients), and others (2 patients: scar and functional), presenting with severe hoarseness that interfered with daily life. Results The mean pre- and post-injective serum bFGF concentration of the 40 patients was 6.689 and 4.658 pg/mL, respectively. The difference in mean serum bFGF concentration between pre- and post-injective was -2.031 pg/mL. The Pearson correlation coefficient was calculated to evaluate the correlation between dosage of trafermin and post-injective serum bFGF concentration, and a moderate correlation was found at r = 0.52. Generalized linear model regression analysis was performed for the purpose of adjusting for confounding among variables. The only variable that showed a statistically predominant association with post-injective serum bFGF concentrations was the dosage of trafermin, with an estimated regression coefficient of 0.048. Conclusion In this study, the dosage of trafermin we injected and post-injective serum bFGF concentrations were dose-dependent but the amount of changes in the serum bFGF concentration was negligible within the physiological range. Therefore, as with subcutaneous and wound administration, intracordal trafermin injections may be safe. Level of Evidence Level IV.
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Affiliation(s)
- Tomohiro Hasegawa
- Tokyo Voice CenterInternational University of Health and WelfareTokyoJapan
| | | | - Ujimoto Konomi
- Voice and Dizziness Clinic Futakotamagawa OtolaryngologyTokyoJapan
| | - Mayu Hirosaki
- Tokyo Voice CenterInternational University of Health and WelfareTokyoJapan
| | - Yuusuke Watanabe
- Tokyo Voice CenterInternational University of Health and WelfareTokyoJapan
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Ng WC, Lokanathan Y, Baki MM, Fauzi MB, Zainuddin AA, Azman M. Tissue Engineering as a Promising Treatment for Glottic Insufficiency: A Review on Biomolecules and Cell-Laden Hydrogel. Biomedicines 2022; 10:3082. [PMID: 36551838 PMCID: PMC9775346 DOI: 10.3390/biomedicines10123082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Glottic insufficiency is widespread in the elderly population and occurs as a result of secondary damage or systemic disease. Tissue engineering is a viable treatment for glottic insufficiency since it aims to restore damaged nerve tissue and revitalize aging muscle. After injection into the biological system, injectable biomaterial delivers cost- and time-effectiveness while acting as a protective shield for cells and biomolecules. This article focuses on injectable biomaterials that transport cells and biomolecules in regenerated tissue, particularly adipose, muscle, and nerve tissue. We propose Wharton's Jelly mesenchymal stem cells (WJMSCs), induced pluripotent stem cells (IP-SCs), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor-1 (IGF-1) and extracellular vesicle (EV) as potential cells and macromolecules to be included into biomaterials, with some particular testing to support them as a promising translational medicine for vocal fold regeneration.
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Affiliation(s)
- Wan-Chiew Ng
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Yogeswaran Lokanathan
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Marina Mat Baki
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mh Busra Fauzi
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Ani Amelia Zainuddin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mawaddah Azman
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Vocal fold sulci - what are the current options for and outcomes of treatment? Curr Opin Otolaryngol Head Neck Surg 2021; 29:458-464. [PMID: 34710065 DOI: 10.1097/moo.0000000000000770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Sulcus vocalis is a benign condition of the vocal folds that, according to its severity, can affect the quality of the voice of those who have it. Voice symptoms can range from mild to severe, affecting the quality of life of patients with this condition. Although different surgical and no surgical options have been described, no gold standard treatment has been described. RECENT FINDINGS New evidence supports congenital, inflammatory, and acquired theories for sulcus vocalis. Also, recent literature demonstrated the role of the epithelium in the pathogenesis, which makes the absence of superficial lamina propria no longer the only accepted hypothesis. Technological developments improved the in-office diagnostics capabilities for this condition, but vocal fold palpation remains the gold standard. Different benign laryngeal conditions are associated with sulcus vocalis and knowing when to treat those is very important. Different treatment options are available for sulcus vocalis, however, results are diverse and no strong recommendations for one over the other can be made. SUMMARY Progress continues to be made in our understanding of sulcus vocalis from diagnosis to treatment. Novel and promising therapeutic strategies have been recently developed for this condition; however, more data and investigations are needed to improve their accuracy and reproducibility.
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