Vokal fold paralizilerinde kalsiyum hidroksilapatit ile enjeksiyon larengoplasti sonuçları

Amaç: Bu yazıda, tek taraflı vokal fold paralizili hastalarda enjeksiyon larengoplasti deneyimlerimiz değerlendirildi.Hastalar ve Yöntemler: Ocak 2005 - Haziran 2012 tarihleri arasında kliniğimizde tek taraflı vokal fold paralizi tanısı konulan ve bu nedenle kalsiyum hidroksilapatit kullanılarak enjeksiyon larengoplasti uygulanan 68 hasta 32 erkek, 36 kadın; ort. yaş 59.5 yıl; dağılım 27-86 yıl çalışmaya dahil edildi.Bulgular: Ortalama takip süresi 36 hafta dağılım 0-340.4 hafta idi. Enjeksiyon sonrası Ses Handikap İndeksi SHİ skoru olan 29 hastanın verileri retrospektif olarak incelendi. Hastaların 16’sı %55 kadın ve ortalama hasta yaşı 60 idi dağılım 27-86 yıl . On yedi hastaya ameliyathanede süspansiyon larengoskopi, 12 hastaya klinik şartlarında perkütan enjeksiyon uygulandı. Enjeksiyon sonrası ortalama SHİ skoru 36.7 idi. Enjeksiyon öncesi ve enjeksiyon sonrası SHİ verileri olan 20 hastanın yarısına perkütan enjeksiyon larengoplasti uygulandı. Bu 20 hastanın ortalama SHİ skoru 27.9 puan artış gösterdi. Ortalama SHİ skoru perkütan grubunda 35.1 puan, süspansiyon grubunda 20.7 puan düzeldi p=0.29 . Akciğer kanseri olan bir hastanın genel sağlığı kötüleşirken enjeksiyon sonrası SHİ skoru düştü.Sonuç: Bu çalışma vokal fold paralizilerinde enjeksiyon larengoplastiyi desteklemektedir. Kalsiyum hidroksilapatit gerek perkütan gerek ameliyathane süspansiyon işlemlerinde güvenilir ve etkili bir tedavi yöntemidir

Anahtar Kelimeler:

Kalsiyum hidroksilapatit, klinik şartlarında işlem, enjeksiyon larengoplasti, ses handikap indeksi

Injection laryngoplasty outcomes in vocal fold paralysis using calcium hydroxylapatite

Objectives: This study aims to evaluate our injection laryngoplasty experience in patients with unilateral vocal fold paralysis. Patients and Methods: Sixty-eight patients 32 males, 36 females; mean age 59.5 years; range 27 to 86 years who were diagnosed with unilateral vocal fold paralysis at our clinic and who underwent injection laryngoplasty using calcium hydroxylapatite between January 2005 and June 2012 were included in this study. Results: Mean follow-up period was 36 weeks range 0-340.4 weeks . Data of 29 patients with post-injection Voice Handicap Index VHI scores were retrospectively analyzed. Of these patients, 16 55% were female, and the mean patient age was 60 range 27 to 86 years . Seventeen patients underwent suspension laryngoscopy in the operating room, 12 patients underwent in-office percutaneous injection. Post-injection mean VHI score was 36.7 range 4 to 87 . Percutaneous injection laryngoplasty was performed to half of the 20 patients with pre- and post-injection VHI data. Mean VHI scores of these 20 patients improved by 27.9 points. Mean VHI score improved by 35.1 points in the percutaneous group, and by 20.7 points in the suspension group p=0.29 . Post-injection VHI score of one patient with lung cancer decreased, as his general health deteriorated. Conclusion: This study supports injection laryngoplasty in vocal fold paralysis. Calcium hydroxylapatite is a safe and effective treatment method in both percutaneous and operating room procedures.

Keywords:

Calcium hydroxylapatite, in-office procedure, injection laryngoplasty, voice handicap index,

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