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PRP Improves Vocal Fold Scar, Atrophy, and Sulcus Vocalis: New Research Review

Published: 03/23/2022

Vocal fold scar, atrophy, and sulcus vocalis with resulting dysphonia are conditions that affect millions of older Americans. Various treatment techniques have been used with limited and inconsistent results.

As a result, researchers and clinicians have looked at alternative treatments using regenerative techniques.

A recent clinical study evaluated the effectiveness of autologous platelet-rich plasma (PRP) injection in 14 patients with vocal fold scar, sulcus, or atrophy. The results showed significant, short-term improvements in vocal function.

Challenges of Treating Vocal Fold Scar, Atrophy, and Sulcus

Vocal fold scar, sulcus vocalis, and atrophy result from changes in the superficial lamina propria that lead to abnormal vocal cord function. Laryngologists use various methods to treat these conditions, including:

  • Augmentation laryngoplasty
  • Tissue implantation
  • Mucosal freeing technique
  • Steroid injection
  • Laser surgery

Unfortunately, none of these procedures provide complete restoration or lasting improvements in vocal function. They continue to pose challenges to clinicians, prompting the need for alternative treatments.

Regenerative medicine techniques, such as autologous PRP injections, have gained interest in recent years, but only a few studies have investigated their use in these disorders.

Clinical Study Shows PRP Improves Voice Quality and Function

The investigators of the present study evaluated 14 patients with vocal fold scar, atrophy, and sulcus vocalis. Among these patients:

  • 12 had a vocal fold scar
  • 1 had a bilateral sulcus vergeture, a defect along the entire length of the vocal fold structure
  • 1 had a vocal atrophy

All patients had previously undergone standard therapy that failed.

The original protocol for the study involved 3 vocal fold injections of PRP for each patient over 3 months. However, patients had the option to decline further treatment if they either felt that the injections were not useful or too stressful, or felt their voice had returned to a satisfactory state.

Two patients took this option, reporting that their voice improved sufficiently after just one injection. Another patient underwent two treatments and declined the third due to COVID-19.

The patients underwent the following evaluations and assessments:

  • A videostroboscopy and clinical examination before and after each injection and at 3 months after the completion of the series
  • Voice Handicap Index (VHI-10) before and after each injection and 3 months following the last treatment, with a follow-up 1 year after the first injection
  • A recording of them saying the CAPE-V sentence “how hard did he hit him” five times in 10 seconds, which was analyzed for the Cepstral Spectral Index of Dysphonia (CSID) score and the Cepstral Peak Prominence (CPP)
  • A survey at the end of the treatment and 1 year following asking if their voice had improved and whether they would consider repeating the treatment

At the initial follow-up, 13 of the 14 patients reported some voice improvements after receiving the PRP injections. Only 1 patient did not report any effects. The median VHI-10, CSID score, and CPP values all improved after the PRP treatments.

The investigators also had an expert speech pathologist rate the CAPE-V audio and compare the video stroboscopy before and after treatment. On acoustic rating, the expert rated 9 in the post treatment to be better. Ten stroboscopy samples were rated as better after treatment, while one was the same.

The results surprised the investigators. Although the improvements could be due to inflammation or volume effect, they noted such improvements would not be expected to last more than 2 weeks.

Many patients experienced ongoing improvements in their voice over the first 3 months after the PRP injection. Five of the 9 patients followed over 1 year had a durable improved vocal function.

A Promising Alternative Therapy to Vocal Ford Scar, Atrophy, and Sulcus Vocalis

While the improvements observed in this study faded over time, the subjective and objective outcomes are encouraging.

PRP injections are a noninvasive and renewable source of growth factors that help heal wounds and regenerate tissues. But anytime a needle is inserted anywhere in the body, there is a risk of infection and bleeding.

The Dr. PRP team understands your concerns. That's why our system is sterile and closed, with the outside air blocked by a double safety cap. In other words, there is no chance of the PRP becoming contaminated. Take a look at our products at our online store.

Ready to see how our kits and centrifuges are different from the rest? Contact us today at 844-377-7787 (DR-PRP-US) to learn how we can help you.