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1.57/C60.4 cc (range 0.6 –2.0 cc) of injectate was used |
The |
average duration of follow-up was 3.6 /C61.8 months. |
Nine patients (75.0%) completed all four PRP injections,while two patients completed three injections and onepatient received only one injection as part of the ongoingtrial |
At the one-month timepoint, one patient requestedto receive the PRP injection in the operating room tobetter tolerate treatment |
All other injections were per-formed in the outpatient clinic setting |
No signi ficant |
inflammatory reactions or adverse events were seen |
to date. |
Patient-reported outcome measures using the VHI- |
10 and VFI questionnaire scores taken at every studyevaluation timepoint are reported in Table |
II |
The VHI- |
10 and VFI scores re flect study participant baseline |
values, 1 week after initial PRP treatment, and everysubsequent treatment timepoint in the trial |
The averageVHI-10 and VFI scores at baseline were 29.7 /C69 and |
45.9/C616.8, respectively |
At 1 week after the first PRP |
injection the average VHI-10 and VFI scores began todowntrend to 27.5 /C610.2 and 42.9 /C616.4 |
At the one- |
month timepoint, the average VHI-10 score of 24.1 /C610.6 |
(median ΔVHI-10 =4.4,p=0.02) and average VFI score |
was 32.1 /C6185 (mean ΔVFI=12.8, p=0.04) re flected |
Fig |
1 |
Clinical vvaluation and study calendar |
This calendar sequentially |
outlines every evaluation and intervention performed along variousstudy timepoints |
Initial, designates the first clinic visit during which |
patients are enrolled in the study |
Day 0, designates the day patients |
receive the first vocal fold injection with PRP, which may be the same |
day as Initial for some |
Subsequent day, week, and month designationsare relative to Day 0 of injection |
H&P =History and Physical; |
Mo=Month; PRP =Platelet-Rich Plasma. |
Laryngoscope 133: March 2023 van der Woerd et al.: Serial PRP Injections for Vocal Fold Atrophy and Scar |
649 |
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the earliest signi ficantly signi ficant decrease in both |
questionnaires |
This signi ficant downtrend persisted |
through the two-month (VHI-10 score 19.9 /C611.3; VFI |
31.1/C614.9) and three-month (VHI-10 18.9 /C612.4; VFI |
25.1/C616.2) timepoints |
At the four-month timepoint, one |
month after the fourth injection, the VHI-10 score was16.4/C614.8 (median ΔVHI-10 =8.4,p=0.03) and the |
VFI score was 14.4 /C611.8 (mean ΔVFI=23.8, p=0.08). |
All patients self-reported tolerating the procedure |
without dif ficulty or immediate complications |
Some |
patients described discomfort associated with thelaryngotracheal anesthetic and mild discomfort was noted |
Fig |
2 |
In-of fice Laryngoscopy photos |
(A) Pre-injection (B) Post-PRP injection (C) 1 month post-injection. |
TABLE I. |
Study Participant Demographic and Pathology Overview. |
Case Age Sex Pathology Prior TreatmentSide of |
InjectionNumber of |
InjectionsAverage Injectate |
(Range cc)Average Follow-up |
Time (Months) |
1 74 M Vocal fold scar and |
atrophyThyroplasty revision, voice |
therapyLeft 4 1.6 (1.5 –2.0) 6 |
2 50 M Vocal fold scar Steroid, injectable filler, |
voice therapyRight 4 1.8 (1.5 –2.0) 6 |
3 49 F Vocal fold scar Voice therapy Right 4 1.8 (1.5 –2.0) 3 |
4 |
81 F Vocal fold scar Injectable filler, Fat |
ImplantationRight 4 1.8 (1.5 –2.0) 5 |
5 62 M Vocal fold scar Thyroplasty Revision, |
Voice TherapyLeft 4 2.0 (2.0) 6 |
6 66 M Vocal fold atrophy Voice therapy Left 4 1.0 (1.0) 4 |
7 61 M Vocal fold scar Thyroplasty revision, voice |
therapyLeft 3 2.0 (2.0) 2 |
8 64 M Vocal fold scar Dupixent, di flucan, voice |
therapyLeft 3 1.5 (1.5) 1 |
9 63 M Vocal fold scar Autologous stem cell |
transplantLeft 4 1.5 (1.0 –2.0) 3 |
10 79 F Bilateral vocal fold |
scarInjectable filler, voice |
therapyLe |
ft 4 1.3 (1.0 –2.0) 3 |
11 44 M Bilateral Vocal fold |
scarSteroid and injectable filler Left 4 1.0 (0.6 –1.5) 3 |
12 45 M Bilateral vocal fold |
scarInjectable filler, voice |
therapyRight 1 1.2 (1.2) 1 |
F=Female; M =Male. |
TABLE II. |
Patient-Reported Outcome Measures after Serial Vocal fold PRP Injections. |
Parameter Baseline 1 Week After 1st Injection 1 Month (2nd injection) 2 Month (3rd Injection) 3 Month (4th Injection) 4 Month |
Patients ( n)1 2 1 1 1 0 1 0 9 5 |
VHI-10 29.7 /C69 27.5 /C610.2 (0.12) 24.1 /C610.67 (0.02) |
* 19.9/C611.3 (0.005) * 18.9/C612.4 (<0.001) * 16.4/C614.8 (0.03) * |
VFI 45.9 /C616.8 42.9 /C616.4 (0.9) 32.1 /C618.5 (0.04) * 31.1/C614.9 (0.04) * 25.1/C616.2 (0.01) * 14.4/C611.8 (0.08) |
VFI=voice fatigue index; VHI-10 =voice handicap index-10. |