Impact of Early Injection Laryngoplasty on Voice Outcomes and Quality of Life in Acute Unilateral Vocal Fold Paralysis

Abdelrhman Ali Kamal, Resident of Otorhinolaryngology, Mansoura University, EgyptFollow
M El-kotb, professor of Otorhinolaryngology, Mansoura University, Egypt
Hemmat Mostafa Baz, Professor of phoniatric medicine ,Mansoura University, Egypt
Ahmed S. Abdelmeguid, Assistant professor of Otorhinolaryngology, Mansoura University, Egypt

Subject Area

Otolaryngology

Article Type

Original Study

Abstract

Background

Unilateral vocal fold paralysis (UVFP) leads to glottic insufficiency, resulting in dysphonia, reduced vocal strength, and frequently swallowing difficulties that impair communication and quality of life. Injection laryngoplasty with temporary materials such as hyaluronic acid has been shown to improve voice quality and phonatory function in UVFP patients and may serve as an effective early intervention prior to permanent medialization surgery.

Objective

To assess the impact of early injection laryngoplasty on voice outcomes and voice related quality of life in patients with acute unilateral vocal fold paralysis.

Methods

This prospective study included 24 patients with acute UVFP treated with early injection laryngoplasty at Mansoura University between September 2024 and January 2026. Voice assessments were performed before injection and at 1 and 6 months post injection using the modified GRBAS scale, acoustic parameters (jitter, shimmer, and harmonics-to-noise ratio), maximum phonation time (MPT), and the Arabic version of the Voice Handicap Index (VHI). Injection laryngoplasty was performed under local or general anesthesia using hyaluronic acid as the injectable material

Results

Significant improvements were observed across all objective acoustic measures, including significant reductions in jitter and shimmer, increased harmonics-to-noise ratio, and longer MPT, indicating enhanced glottic efficiency and voice stability. Subjective assessments demonstrated significant improvements in modified GRBAS scores and Arabic VHI scores at both 1-month and 6-month follow-ups. No major injection-related complications were reported. Notably, a high proportion of patients did not require subsequent permanent surgical medialization procedures during follow-up.

Conclusion

Early injection laryngoplasty with hyaluronic acid is a safe and effective intervention for acute unilateral vocal fold paralysis, resulting in significant improvements in objective and subjective voice outcomes, as well as voice-related quality of life, with a low incidence of significant adverse events. Early intervention may also reduce the need for later permanent medialization surgery.

Recommended Citation

Kamal, Abdelrhman Ali; El-kotb, M; Baz, Hemmat Mostafa; and Abdelmeguid, Ahmed S. (2026) "Impact of Early Injection Laryngoplasty on Voice Outcomes and Quality of Life in Acute Unilateral Vocal Fold Paralysis," Mansoura Medical Journal: Vol. 55 : Iss. 6 , Article 17.
Available at: https://doi.org/10.58775/2735-3990.1545