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Quality of the voice after injection of hyaluronic acid into the vocal fold

Agata Szkiełkowska, Beata Miaśkiewicz, Marc Remacle, Paulina Krasnodębska, Henryk Skarżyński

Med Sci Monit 2013; 19:276-282

DOI: 10.12659/MSM.883888

Available online:

Published: 2013-04-17

Background: Voice disorders resulting from glottic insufficiency are a significant clinical problem in everyday phoniatric practice. One method of treatment is injection laryngoplasty. Our study aimed to assess the voice quality of patients treated with hyaluronic acid injection into the vocal fold.
Material and Methods: We studied 25 patients suffering from dysphonia, conducting laryngological and phoniatric examination, including videostroboscopy and acoustic voice analysis, before the operation and 1, 3, and 6 months later.
Results: In all cases there was complete or almost complete glottic closure after the operation. One month after the procedure, videostroboscopic examination revealed reappearance of vocal fold vibration in 8 cases; after 3 months this had risen to 15 cases. Perceptual voice quality (as assessed by the GRBAS scale) in patients with glottic insufficiency was improved. The most significant improvement was obtained 1 month after surgery (p=0.0002), and within the next months further statistically significant improvements (p=0.000002) were noted. Multidimensional voice analysis showed statistically significant and rapid improvement in frequency parameters, especially vFo. Other parameters were also improved 3 and 6 months after surgery.
Conclusions: Injection of hyaluronic acid into the vocal fold improves phonatory functions of the larynx and the quality of voice in patients with glottic insufficiency. It may be a safe and conservative method for treatment of voice disorders. Hyaluronic acid injection to the vocal fold is an easy, effective, and fast method for restoration of good voice quality.

Keywords: Vocal Cord Paralysis - surgery, Stroboscopy, Injections, Hyaluronic Acid - therapeutic use, Adult, Acoustics, Vocal Cords - surgery, Voice Quality - drug effects