Safety and efficacy of carboxymethylcellulose in the treatment of glottic insufficiency

Pavan S. Mallur, Michele P. Morrison, Gregory N Postma, Milan R. Amin, Clark A. Rosen

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives/Hypothesis: No studies to date have examined the clinical safety and efficacy of carboxymethylcellulose (CMC) for vocal fold injection. The current study investigates the voice outcomes and complications of CMC injection. Study Design: Retrospective review. Methods: All patients who underwent CMC injection from three independent sites in a 1-year period were reviewed. Voice outcomes in the form of voice handicap index-10 (VHI-10) and complications from injection were recorded. Results: Seventy-eight patients with VHI-10 results from 1 to 8 weeks after CMC injection were evaluated. Thirty-eight patients were treated for vocal fold immobility, and 15 patients underwent treatment for hypomobility, 15 for vocal fold atrophy, seven for scar/sulcus, one for previous laryngeal fracture, one for functional dysphonia, and one for persistent granuloma. In 60 patients with available VHI-10 data, overall improvement in voice was seen. There was a mean decrease in VHI-10 of 7.48 (26.4 to 18.9, P <.05), correlating to a 19.9% decrease. Forty-five patients (75%) showed a decrease in VHI-10, nine (15%) showed an increase, and six (10%) showed no change. Statistically significant differences were seen for patients with immobility (decrease of 8.6, or 31%) and hypomobility (decrease of 10.7, or 37.8%). There were no complications of vocal fold stiffness, inflammatory reaction, or scar in the 78 patients during the total follow-up period. Conclusions: CMC is a viable, safe, and efficacious material for the temporary treatment of glottic insufficiency in vocal fold immobility and hypomobility, with minimal risk of permanent adverse voice outcomes.

Original languageEnglish (US)
Pages (from-to)322-326
Number of pages5
JournalLaryngoscope
Volume122
Issue number2
DOIs
StatePublished - Feb 1 2012

Fingerprint

Carboxymethylcellulose Sodium
Tongue
Safety
Vocal Cords
Injections
Therapeutics
Cicatrix
Dysphonia
Granuloma
Atrophy
Retrospective Studies

Keywords

  • Level of Evidence: 4
  • Vocal fold injection
  • carboxy-methylcellulose
  • injection laryngoplasty
  • temporary vocal fold injection
  • trial vocal fold injection
  • vocal cord paralysis
  • vocal cord paresis

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Safety and efficacy of carboxymethylcellulose in the treatment of glottic insufficiency. / Mallur, Pavan S.; Morrison, Michele P.; Postma, Gregory N; Amin, Milan R.; Rosen, Clark A.

In: Laryngoscope, Vol. 122, No. 2, 01.02.2012, p. 322-326.

Research output: Contribution to journalArticle

Mallur, Pavan S. ; Morrison, Michele P. ; Postma, Gregory N ; Amin, Milan R. ; Rosen, Clark A. / Safety and efficacy of carboxymethylcellulose in the treatment of glottic insufficiency. In: Laryngoscope. 2012 ; Vol. 122, No. 2. pp. 322-326.
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abstract = "Objectives/Hypothesis: No studies to date have examined the clinical safety and efficacy of carboxymethylcellulose (CMC) for vocal fold injection. The current study investigates the voice outcomes and complications of CMC injection. Study Design: Retrospective review. Methods: All patients who underwent CMC injection from three independent sites in a 1-year period were reviewed. Voice outcomes in the form of voice handicap index-10 (VHI-10) and complications from injection were recorded. Results: Seventy-eight patients with VHI-10 results from 1 to 8 weeks after CMC injection were evaluated. Thirty-eight patients were treated for vocal fold immobility, and 15 patients underwent treatment for hypomobility, 15 for vocal fold atrophy, seven for scar/sulcus, one for previous laryngeal fracture, one for functional dysphonia, and one for persistent granuloma. In 60 patients with available VHI-10 data, overall improvement in voice was seen. There was a mean decrease in VHI-10 of 7.48 (26.4 to 18.9, P <.05), correlating to a 19.9{\%} decrease. Forty-five patients (75{\%}) showed a decrease in VHI-10, nine (15{\%}) showed an increase, and six (10{\%}) showed no change. Statistically significant differences were seen for patients with immobility (decrease of 8.6, or 31{\%}) and hypomobility (decrease of 10.7, or 37.8{\%}). There were no complications of vocal fold stiffness, inflammatory reaction, or scar in the 78 patients during the total follow-up period. Conclusions: CMC is a viable, safe, and efficacious material for the temporary treatment of glottic insufficiency in vocal fold immobility and hypomobility, with minimal risk of permanent adverse voice outcomes.",
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