Easier-to-Use Vocal Fold Injectables Prompt More In-Office Procedures

A prospective study of 36 patients with the adductory form of spasmodic dysphonia who were treated with Botox up to six times showed good results, according to senior author Norman D. Hogikyan, MD, Director of the University of Michigan Health System Vocal Health Center in Ann Arbor.

As rated on a 100-point Voice-Related Quality of Life measure developed by the researchers, the patients improved from an average score of 32.7 points before the first injection to an average score of around 80.6 points by the end of treatment.

The average time between injections for study participants was 25 weeks. During the study period, 23 patients required at least two injections, five of whom required six injections.

The Future of Vocal Fold Injections

So what is on the horizon?

For starters, there may a rise in voice fold injections for age-associated vocal fold bowing, specialists say.

As we age, presbylaryngitis sets in and we lose muscles in our voice folds like everywhere else. This can result in lower pitch, fatigue when speaking, and an inability to maintain a high volume, Dr. Shaw said. Vocal fold injections can restore some of that bulk that you have lost.

The procedure is sometimes referred to as voice lift surgery, as a rise in procedures in Europe appears to accompany an increase in the popularity of cosmetic surgery. Baby boomers who have face lifts and other procedures see a disparity between their appearance and their vocal age, resulting in a demand for a younger voice.

It’s already picking up in Europe and I wouldn’t be surprised if we see an increase in requests over the next few years here, Dr. Shaw said.

Dr. Garrett said she objected to the term voice lifts. Some people in their fifties might not otherwise be able to do their jobs because their voices are too weak, for example. It is not the equivalent of a face lift for cosmetic reasons, she said.

As for injectable materials, new products in the pipeline include stem cells in matrix, cells in atelopeptide collagen for tissue regeneration, cultured autologous fibroblasts, autologous fibroblasts to improve vocal cord scarring, and bioreactors for stimulating vocal fold biomechanics, according to Dr. DeVore.

Animal results of some of these approaches have already been reported. In one study, researchers successfully repaired the damaged vocal cords of eight adult beagle dogs using selective cultured autologous mesenchymal stem cells (Ann Otol Rhinol Laryngol 2003;112:915-20).