Vocal fold augmentation with calcium hydroxylapatite

Peter C. Belafsky, Gregory N Postma

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Objectives Voice disorders affect more than 3% of the general population. Vocal fold atrophy is a part of the normal aging process, with up to 60% of 60-year-old individuals displaying evidence of glottal insufficiency. A safe, effective, and durable substance for injection augmentation of the vocal folds is not currently available. The purpose of this investigation was to describe our preliminary experience with calcium hydroxylapatite (CaHA) for vocal fold augmentation. Methodology All patients undergoing injection augmentation of the vocal folds with CaHA between January 1, 2002 and June 1, 2003 were prospectively evaluated. Data concerning indications, technique, functional outcome, and complications were collected. In addition, the larynx donated from a woman who underwent vocal fold augmentation with CaHA and subsequently died from terminal cancer was histologically examined. Results A total of 39 vocal folds in 23 individuals were injected with CaHA. The mean age of the cohort was 62. Fifty-two percent were male. The indications for augmentation were unilateral vocal fold paralysis (9/23), unilateral vocal fold paresis (5/23), presbylarynx (3/23), Parkinson's (3/23), bilateral vocal fold paresis (2/23), and abductor spasmodic dysphonia (1/20). There were no adverse reactions. All individuals reported improvement on a self-administered disease-specific outcome measure (P < 0.001). The pathology from the donated larynx 3 months after injection revealed intact CaHA spherules in good position with a minimal, monocellular inflammatory reaction to the gel carrier and no evidence of implant rejection. Conclusions Initial experience with vocal fold augmentation using CaHA is promising. Long-term safety and efficacy needs to be established.

Original languageEnglish (US)
Pages (from-to)351-354
Number of pages4
JournalOtolaryngology - Head and Neck Surgery
Volume131
Issue number4
DOIs
StatePublished - Oct 1 2004
Externally publishedYes

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Vocal Cords
Durapatite
Calcium
Paresis
Larynx
Injections
Voice Disorders
Dysphonia
Paralysis
Atrophy
Gels
Outcome Assessment (Health Care)
Pathology
Safety

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Vocal fold augmentation with calcium hydroxylapatite. / Belafsky, Peter C.; Postma, Gregory N.

In: Otolaryngology - Head and Neck Surgery, Vol. 131, No. 4, 01.10.2004, p. 351-354.

Research output: Contribution to journalArticle

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