Regenerative Phonosurgical Treatments for Vocal Fold Scar and Sulcus With Basic Fibroblast Growth Factor

Objectives/HypothesisVocal fold scar and sulcus are still challenges. Basic fibroblast growth factor (bFGF) has proven to be effective to resolve scar tissue in animal models. This study reports the efficacy of regenerative treatments using bFGF on vocal fold scar and sulcus in human cases. Study DesignRetrospective chart review. MethodsFifteen cases (7 scar; 8 sulcus) were treated by either local injection of bFGF (n=6) or regenerative surgery using bFGF (n=9). Injection regimen was to locally apply 10 micrograms of bFGF in 0.5 mL saline into each vocal fold under topical anesthesia repeatedly (4 times with intervals of 1 week between each injection). The regenerative surgical procedure consisted of the dissection of scar tissue and the implant of gelatin sponge with bFGF. Follow-up periods ranged from 6 months to 24 months. ResultsMaximum Phonation Time (MPT); Voice Handicap Index (VHI)-10; and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale were assessed in both groups. The injection group showed significant improvement on VHI-10 and GRBAS. The regenerative surgery group showed significant improvement in all parameters. Jitter and shimmer were evaluated in the surgery group, and the results indicated improvement in six and five cases of nine cases, respectively. No major adverse effects were observed in both treatment groups. ConclusionsRegenerative treatments using bFGF has shown to be effective for improvement of vocal function in scar and sulcus. Level of Evidence4. Laryngoscope, 123:2749-2755, 2013