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Hyaluronic acid injection laryngoplasty significantly improves voice quality, phonation time, and glottal closure in unilateral vocal fold paralysis.
A new systematic review and meta-analysis has revealed that hyaluronic acid (HA) injection laryngoplasty substantially improves voice outcomes in adults suffering from unilateral vocal fold paralysis (UVFP) — a condition often caused by nerve injury during head and neck surgeries.
UVFP leads to incomplete closure of the vocal folds, resulting in hoarseness, difficulty speaking, and diminished quality of life. HA, a naturally occurring molecule known for its viscoelastic and tissue-friendly properties, is increasingly being employed to restore vocal fold function. To assess how effective HA is in treating UVFP, researchers examined data from 32 clinical studies that included a total of 1,917 adult patients. Endpoints like maximal phonation time (MPT), normalized glottal gap area (NGGA), and voice-related quality of life were examined.
Meta-analysis results confirmed remarkable enhancements in multiple clinical outcomes. Voice-related quality of life improved notably in both short- and medium-term follow-ups, showing a standardized mean difference (SMD) of 0.87 and no heterogeneity (I² = 0%). Patients also experienced meaningful gains in vocal endurance: MPT substantially increased in the medium term (SMD = 0.45; I² = 2%). Additionally, NGGA — a key indicator of vocal fold closure — exhibited marked medium-term reduction (SMD = 0.51; I² = 0%), highlighting improved glottal competence and better sound production.
Safety assessment revealed that adverse effects were rare and mild, consisting mainly of temporary hoarseness or transient inflammatory reactions, with no major long-term complications reported. Study quality was rated favorably, with a low overall risk of bias, strengthening the validity of the findings. Overall, this high-quality analysis establishes HA injection laryngoplasty as a valuable and safe therapeutic strategy for rapid voice restoration in UVFP. Researchers also emphasized the need for future trials to examine long-term durability, patient-specific response predictors, and standardized treatment protocols across diverse populations.
Cureus
The Use of Hyaluronic Acid in the Treatment of Unilateral Vocal Fold Paralysis: A Systematic Review and Meta-Analysis
Khalid M Alkhalifah et al.
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