Bioplastique™ injection laryngoplasty: voice performance outcome 1
Aim: To compare voice performance following Bioplastique™ injection with that following Isshiki thyroplasty.
Measures: A 12 item, self-reported voice performance questionnaire was completed and observer-rated perceptual voice analysis scores were also measured, before and after Bioplastique injection, for 14 patients. Results were compared with our previously reported outcomes for 28 thyroplasty patients.
Results: Only 14 of 30 patients had complete datasets. For these patients, the mean pre-operative voice performance questionnaire score improved significantly, from 40.3 to 18.9 (p=0.002, Wilcoxon test). All perceptual analysis parameters showed significant improvement. These results compare favourably with the thyroplasty cohort (mean voice performance questionnaire score: pre-operative 35; post-operative 18; p<0.001). One Bioplastique patient developed contralateral paresis, requiring partial removal of the material 18 months later. Two thyroplasty patients experienced complications and three required revision.
Conclusions: Both Bioplastique injection and Isshiki thyroplasty resulted in a significant improvement in both subjective and perceptual voice performance. Our data suggest that the effect size of the two interventions is approximately similar (in nonrandomised cohorts of surviving patients). As in many similar studies, the incomplete follow-up data reflect severe comorbidity. Bioplastique injection is a quicker procedure associated with fewer complications, and thus appears superior to framework surgery in patients with limited life expectancy.(Published Online December 12 2006)
(Accepted October 5 2006)
Key Words: Bioplastique™; Vocal Cord Palsy; Isshiki Thyroplasty; Voice Performance Questionnaire.
c1 Address for correspondence: Mr David Hamilton, 59 Lavender Gardens, Jesmond, Newcastle Upon Tyne NE2 3DD, UK. E-mail: [email protected]
1 Presented in part at the International Federation of Otorhinolaryngologists, XVIII World Congress, 25th to 30th June 2005 in Rome, Italy, and at the North of England Otolaryngology Society Spring Meeting, 12th March 2005 in Middlesbrough, England, UK.