Intracordal Injection of Basic Fibroblast Growth Factor in 100 Cases of Vocal Fold Atrophy and Scar
Intracordal Injection of Basic Fibroblast Growth Factor in 100 Cases of Vocal Fold Atrophy and Scar
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DOI：
10.1002/lary.29200
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发表时间：
2020-10-27
期刊：
影响因子：
2.6
通讯作者：
Hashimoto, Keiko
中科院分区：
文献类型：
--
作者：
Hirano, Shigeru;Sugiyama, Yoichiro;Hashimoto, Keiko
目的/假设声带萎缩、瘢痕和声带沟降低了声带粘膜的振动功能，从而导致严重的顽固性发声困难。我们已经报告了令人鼓舞的初步结果，使用声带内注射碱性成纤维细胞生长因子（bFGF），并表现出改善发声参数和声音。方法对100例声带病变患者（其中声带萎缩43例，声带瘢痕41例，声带沟16例）进行局部注射bFGF治疗，并对治疗前后的临床资料进行回顾性分析。在表面麻醉下，将10 μ g bFGF注射到每个患者的声带中4次。结果所有病理组的MPT、VHI-10和GRBAS评分均明显改善。在82%的萎缩病例、78%的瘢痕病例和67%的沟病例中观察到VHI-10改善大于5分。萎缩组VHI-10的改善明显优于瘢痕组或沟组。轻/中度的疤痕和沟的情况下，表现出更好的改善比严重cases.Conclusions目前的大型病例系列表明，积极的影响，脊髓内注射bFGF改善声音，没有严重的不良事件。对于萎缩的病例效果最好，而对于严重瘢痕和沟的治疗需要进一步改进。证据等级4喉镜，2020
Objectives/Hypothesis Vocal fold atrophy, scar, and sulcus reduce the vibratory function of the vocal fold mucosa, which causes severe refractory dysphonia. We have reported encouraging preliminary results using an intracordal injection of basic fibroblast growth factor (bFGF) and showed improvement in phonatory parameters and voice. The present study summarizes our experience with 100 cases of stiffened vocal folds that were treated with bFGF injections.Study Design Retrospective chart review with Interstitial Review Board (IRB) approval.Methods Local injection of bFGF was performed in 100 cases of vocal fold pathology, which included 43 cases of vocal fold atrophy, 41 cases with scar, and 16 cases with sulcus. Ten micrograms of bFGF were injected into the vocal folds under topical anesthesia 4 times in each patient. Therapeutic outcomes were examined with maximum phonation time (MPT), voice handicap index-10 (VHI-10), and GRBAS scale.Results MPT, VHI-10, and GRBAS scores significantly improved in all pathology groups. An improvement on the VHI-10 greater than five points was observed in 82% of atrophy cases, 78% of scar cases, and 67% of sulcus cases. Improvement on the VHI-10 was significantly better in the atrophy group than the scar or sulcus groups. The mild/moderate cases of scar and sulcus showed better improvement than severe cases.Conclusions The current large case series indicates positive effects of intracordal injection of bFGF for improvement of voice with no severe adverse events. The effects appeared best for cases of atrophy, while the treatment of severe scar and sulcus requires further improvement.Level of Evidence 4 Laryngoscope, 2020