Long-term results of calcium hydroxylapatite for vocal fold augmentation.

OBJECTIVES/HYPOTHESIS Studies have shown excellent results for 12-month post-injection augmentation data for calcium hydroxylapatite (CaHA) for glottal incompetence; however, the longevity of the material past one year was unknown. Our objective was to report the long-term effectiveness of CaHA as a vocal fold injectable by assessing data from a cohort of patients who underwent injection for glottal insufficiency. STUDY DESIGN Retrospective chart review. METHODS Patients who underwent CaHA injection for glottal insufficiency of any etiology were considered for inclusion in the study. The change in Voice Handicap Index (VHI)-10 scores between preinjection scores and best postinjection scores as well as between the preinjection and the most recent VHI-10 scores were used as primary outcome measures to determine the persistence of benefit or the time to loss of benefit. Complications among the cohort were identified. RESULTS Ninety patients who underwent 108 vocal fold injections with CaHA were evaluated for inclusion. Twenty patients with 22 injections met the criteria for inclusion. Fourteen of 22 (64%) subjects showed loss of benefit of the CaHA material. The average length of benefit was 18.6 months, with a range of 8 to 36 months. Three complications were identified among the original cohort of 108 injections. CONCLUSIONS CaHA remains a safe and effective long-term vocal fold injectable with an average length of benefit of 18.6 months. Three complications were seen among 108 CaHA injections. CaHA is a long-term injectable with an excellent track record that does not appear to warrant concern for permanent or late complications.