Polydimethylsiloxane (PDMS) is widely used for vocal cord injections to treat patients with a vocal cord palsy. It is commercially available as the Vox implant system. Alternative compounds that can be employed include hyaluronic acid and calcium hydroxyapatite (Radiesse Voice). These latter materials are reabsorbed (slowly in the case of calcium hydroxyapatite) whilst PDMS is considered to be non-absorbable. This retrospective study provides further evidence to support the notion that the results obtained with PDMS injections are stable over a prolonged period of time. Twenty-six patients with a unilateral vocal cord palsy who had not improved with conservative measures including voice therapy over 12 months were treated with PDMS injections. Procedures were performed via direct laryngoscopy under a general anaesthetic with two injection points (lateral to mid cord and posterior third of cord). Results were assessed in terms of the GRBAS scale, change in VHI and mean phonation time among other parameters. Patients in this study were followed up for a minimum of three years (mean follow-up duration 73 months). All subjective and objective measures of voice quality improved significantly postoperatively. There were no significant differences in terms of outcome measurements between immediate postoperative results and long term results. No complications were reported in this series. As such, the authors conclude – quite reasonably, acknowledging the limitation of small patient numbers – that PDMS injection laryngoplasty is a safe and effective procedure for unilateral vocal fold paralysis, providing durable results over many years.

Polydimethylsiloxane injection laryngoplasty for unilateral vocal fold paralysis: long-term results.
Mattioli F, Bettini M, Botti C, et al.
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Christopher Burgess

Musgrove Park Hospital, Taunton, UK.

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