Collagen Augmentation of Vocal Folds for Hypophonia
The effects of collagen augmentation of the vocal folds via percutaneous injection and with fiberoptic guidance on phonation in hypophonic individuals with PD were reported in two studies. Berke et al. (109) assessed 35 hypophonic PD patients treated with collagen augmentation with a telephone survey and found that 75% expressed satisfaction with the improvement in their voice, compared with 16% who expressed dissatisfaction with the results of collagen augmentation. Kim et al. (110), using a telephone interview of 18 PD patients treated with this procedure, found that 11 patients (61%) considered their voice improved for at least two months. Of the seven patients who were not improved with this procedure, five (28%) were aphonic before and after the collagen injection. They concluded that although the majority of patients are likely to benefit from the procedure, patients with advanced neurologic disease with aphonia, difficulty with speech initiation, dysphagia, or ambulatory difficulty are less likely to respond to this procedure. Although these preliminary results are promising, more objective methods of voice evaluation are needed, as are long-term, controlled outcome studies.
Born et al. (111) assessed the effects of cricopharyngeal myotomy in four patients with PD and dysphagia associated with cricopharyngeal dysfunction, diagnosed with radiological and manometric methods. They reported positive results with sustained improvement in swallowing.
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