bvand086/sciwritingdataset · Datasets at Hugging Face

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research: a journal of the international cannabinoid research society
Cannabis Cannabinoid Res
2019;4:259–264
Journal of Voice, Vol
xx, No
xx, xxxx 8
Downloaded for Anonymous User (n/a) at McMaster University from ClinicalKey.com by Elsevier on September 08,
2023
For personal use only
No other uses without permission
Copyright ©2023
Elsevier Inc
All rights reserved.
Safety of Platelet-Rich Plasma Subepithelial Infusion for Vocal Fold
Scar, Sulcus, and Atrophy
Benjamin van der Woerd, MD; Karla O ’Dell, MD; Carlos X Castellanos, MS ; Neel Bhatt, MD;
Yael Benssousan, MD ; Neha K Reddy, BA; Timothy Blood, MD; Dinesh K Chhetri, MD;
Michael M Johns III MD
Objective: To demonstrate the safety pro ﬁle of platelet-rich plasma (PRP) as an injectable therapeutic for the treatment
of vocal fold scarring and atrophy.
Methods: Preliminary report on a prospective clinical tr ial of p
atients with vocal fold scar or atrophy
undergoing unilateral vocal fold subepithelial infusion with autologous PRP
Enrolled patients underwent four sub-
epithelial injections spaced 1 month apart
Adverse event s were assessed peri and post-injection at each session.
Patient-reported outcomes were collected at every visit us ing the Voice Handicap Index-10 (VHI-10) and Vocal Fatigue
Index (VFI) questionnaires.
Results: Twelve patients underwent unilateral vocal fold injection with autologous PRP prepared according to Eclipse
PRP®system protocol
Forty-three injections were performed using a peroral or percutaneous approach
An average of
1.57/C60.4 cc (range 0.6 –2.0 cc) injectate was used
All patients tolerated the procedure without dif ﬁculty or peri-procedural
complications
The average duration of follow-up was 3.6 /C61.8 months
No signi ﬁcant in ﬂammatory reactions or adverse
events were seen to date
There was statistically signi ﬁcant improvement in patient-reported outcomes at the 3 month follow
up ( n=9) follow-up (mean ΔVHI-10 =10.8, p< 0.001, mean ΔVFI=18.9, p=0.01, ttest, paired two sample for means, two-
tail)
All nine patients who completed the series of four injections subjectively (yes/no) reported they were satis ﬁed with the
results.
Conclusion: This prospective study cohort demonstrated a favorable safety pro ﬁle, with no adverse events or
peri-procedural complications
Subjective improvements in vocal quality and reduction in vocal fatigue need to be clinically
correlated with further study.
Key Words: platelet-rich plasma, vocal fold scar, super ﬁcial lamina propria, vocal fold atrophy.
Level of Evidence: 4
Laryngoscope , 133:647 –653, 2023
INTRODUCTION
Vocal fold atrophy and scar are causes of dysphonia
that pose major treatment challenges for laryngologists.1
The etiology of vocal fold scar is diverse, potentially stem-ming from phonotrauma, phonomicrosurgery, iatrogen
ic
injury, malignancy, and radiation therapy.
2,3Addition-
ally, loss of hyaluronic acid, elastic ﬁbers, and lubrication
during the aging process can reduce viable tissue mass.4
Underlying alterations to the super ﬁcial lamina propria
(SLP) of the vocal folds drastically alter compliance.5Con-
sequently, patients endure considerable dysphonia, vocal
fatigue, decreased volume, and altered pitch
These
changes can contribute to depression, reduced social
interaction, and decreased quality of life.6
The most common initial treatment for vocal fold atro-
phy condition is voice therapy administered by a specialized
speech-language pathologist spaced out over multiple
monthly sessions
Voice therapy introduces logistical strains
in the elderly population, such as coordinating tr ansportation
across several sessions, and is limited by its inability to
restore normal vocal fold volume and morphology.5Alterna-
tively, injectable ﬁller materials (e.g., carboxymethylcellulose
and micronized collagen) may be used to augment the vocal
folds for patients with glottic insuf ﬁciency secondary to loss of
the SLP.7However, this treatment is temporary and fails toThis is an open access article under t
he terms of the Creative
Commons Attribution-NonCommercial-NoDerivs License, which permits
use and distribution in any medium, provided the original work is prop-
erly cited, the use is non-commercial and no modi ﬁcations or adaptations
are made.
From the USC Voice Center, Department of Otolaryngology –
Head & Neck Surgery ( B.V.D.W.,K.O.,M.M.J.), University of Southern
California, Los Angeles, California, U.S.A.; Department of OtolaryngologyHead and Neck Surgery (
C.X.C.), Keck School of Medicine of the Un
iversity
of Southern California, Los Angeles, California, U.S.A.; Department ofOtolaryngology –Head & Neck Surgery (
N.B.), University of Washington
School of Medicine, Seattle, Washington, U.S.A.; USF Health Voice
Center, Department of Otolaryngology –Head & Neck Surgery ( Y.B.),
University of South Florida, Tampa, Florida, USA; Department ofHead and Neck Surgery (
N.K.R.), David Geffen School of Medicine at the
University of California, Los Angeles, California, U.S.A.; and the Division ofHead and Neck Sur
gery (
T.B.,D.K.C.), David Geffen School of Medicine
at the University of California, Los Angeles, California, U.S.A.
Editor ’s Note: This Manuscript was accepted for publication on
June 6, 2022.

research: a journal of the international cannabinoid research society

Cannabis Cannabinoid Res

2019;4:259–264

Journal of Voice, Vol

xx, No

xx, xxxx 8

Downloaded for Anonymous User (n/a) at McMaster University from ClinicalKey.com by Elsevier on September 08,

2023

For personal use only

No other uses without permission

Elsevier Inc

Safety of Platelet-Rich Plasma Subepithelial Infusion for Vocal Fold

Scar, Sulcus, and Atrophy

Benjamin van der Woerd, MD; Karla O ’Dell, MD; Carlos X Castellanos, MS ; Neel Bhatt, MD;

Yael Benssousan, MD ; Neha K Reddy, BA; Timothy Blood, MD; Dinesh K Chhetri, MD;

Michael M Johns III MD

Objective: To demonstrate the safety pro ﬁle of platelet-rich plasma (PRP) as an injectable therapeutic for the treatment

of vocal fold scarring and atrophy.

Methods: Preliminary report on a prospective clinical tr ial of p

atients with vocal fold scar or atrophy

undergoing unilateral vocal fold subepithelial infusion with autologous PRP

Enrolled patients underwent four sub-

epithelial injections spaced 1 month apart

Adverse event s were assessed peri and post-injection at each session.

Patient-reported outcomes were collected at every visit us ing the Voice Handicap Index-10 (VHI-10) and Vocal Fatigue

Index (VFI) questionnaires.

Results: Twelve patients underwent unilateral vocal fold injection with autologous PRP prepared according to Eclipse

PRP®system protocol

Forty-three injections were performed using a peroral or percutaneous approach

An average of

1.57/C60.4 cc (range 0.6 –2.0 cc) injectate was used

All patients tolerated the procedure without dif ﬁculty or peri-procedural

complications

The average duration of follow-up was 3.6 /C61.8 months

No signi ﬁcant in ﬂammatory reactions or adverse

events were seen to date

There was statistically signi ﬁcant improvement in patient-reported outcomes at the 3 month follow

up ( n=9) follow-up (mean ΔVHI-10 =10.8, p< 0.001, mean ΔVFI=18.9, p=0.01, ttest, paired two sample for means, two-

tail)

All nine patients who completed the series of four injections subjectively (yes/no) reported they were satis ﬁed with the

results.

Conclusion: This prospective study cohort demonstrated a favorable safety pro ﬁle, with no adverse events or

peri-procedural complications

Subjective improvements in vocal quality and reduction in vocal fatigue need to be clinically

correlated with further study.

Key Words: platelet-rich plasma, vocal fold scar, super ﬁcial lamina propria, vocal fold atrophy.

Level of Evidence: 4

Laryngoscope , 133:647 –653, 2023

INTRODUCTION

Vocal fold atrophy and scar are causes of dysphonia

that pose major treatment challenges for laryngologists.1

The etiology of vocal fold scar is diverse, potentially stem-ming from phonotrauma, phonomicrosurgery, iatrogen

ic

injury, malignancy, and radiation therapy.

2,3Addition-

ally, loss of hyaluronic acid, elastic ﬁbers, and lubrication

during the aging process can reduce viable tissue mass.4

Underlying alterations to the super ﬁcial lamina propria

(SLP) of the vocal folds drastically alter compliance.5Con-

sequently, patients endure considerable dysphonia, vocal

fatigue, decreased volume, and altered pitch

These

changes can contribute to depression, reduced social

interaction, and decreased quality of life.6

The most common initial treatment for vocal fold atro-

phy condition is voice therapy administered by a specialized

speech-language pathologist spaced out over multiple

monthly sessions

Voice therapy introduces logistical strains

in the elderly population, such as coordinating tr ansportation

across several sessions, and is limited by its inability to

restore normal vocal fold volume and morphology.5Alterna-

tively, injectable ﬁller materials (e.g., carboxymethylcellulose

and micronized collagen) may be used to augment the vocal

folds for patients with glottic insuf ﬁciency secondary to loss of

the SLP.7However, this treatment is temporary and fails toThis is an open access article under t

he terms of the Creative

Commons Attribution-NonCommercial-NoDerivs License, which permits

use and distribution in any medium, provided the original work is prop-

erly cited, the use is non-commercial and no modi ﬁcations or adaptations

are made.

From the USC Voice Center, Department of Otolaryngology –

Head & Neck Surgery ( B.V.D.W.,K.O.,M.M.J.), University of Southern

California, Los Angeles, California, U.S.A.; Department of OtolaryngologyHead and Neck Surgery (

C.X.C.), Keck School of Medicine of the Un

iversity

of Southern California, Los Angeles, California, U.S.A.; Department ofOtolaryngology –Head & Neck Surgery (

N.B.), University of Washington

School of Medicine, Seattle, Washington, U.S.A.; USF Health Voice

Center, Department of Otolaryngology –Head & Neck Surgery ( Y.B.),

University of South Florida, Tampa, Florida, USA; Department ofHead and Neck Surgery (

N.K.R.), David Geffen School of Medicine at the

University of California, Los Angeles, California, U.S.A.; and the Division ofHead and Neck Sur

gery (

T.B.,D.K.C.), David Geffen School of Medicine

at the University of California, Los Angeles, California, U.S.A.

Editor ’s Note: This Manuscript was accepted for publication on

June 6, 2022.