- Email: [email protected]
Vocal Fold Augmentation with Calcium Hydroxylapatite (CaHA)
Otolaryngology– Head and Neck Surgery Volume 133 Number 2
8:56
AM
Vocal Fold Augmentation with Calcium Hydroxylapatite (CaHA) Clark A Rosen, MD (presenter); Jackie Gartner-Schmidt, PhD; Timothy D Anderson, MD; Roy R Casiano, MD; Marc J Remacle, MD PhD; Lee A Reussner, MD; Robert T Sataloff, MD; Felicia L Johnson, MD
•
Scientific Session: Head and Neck Surgery LACC Room 408B Moderators: Eduardo M. Diaz, Jr., MD; B. Tucker Woodson, MD
8:00
AM
State of the Art in Pediatric Microvascular Reconstruction David Jack Arnold, MD (presenter); Mark K Wax, MD Miami FL; Portland OR
Objectives: To review the composite experience of the members of the microvascular committee and their respective institutions with respect to the treatment of pediatric patients using microvascular reconstructive techniques. Methods: All members of the committee were asked to review their institution’s cumulative experience with microvascular free flap reconstruction in the pediatric age group which was defined as age less than or equal to 21 years at the time of reconstruction. Specific data was collected and included: age at reconstruction, defect to be reconstructed, type of flap used, details of vascular anastamoses, donor site morbidity, flap viability, and need for flap revision.
Pittsburgh PA; Pittsburgh PA; Belmont MA; Miami FL; Yvoir Belgium; Lawrence KS; Philadelphia PA; Little Rock AR
Objectives: Evaluate the effectiveness of CaHA injection for patients with glottal incompetence. Methods: Multi-center, open-label, prospective clinical study with each patient serving as his/her own control. Voice related outcome measures were collected for pre-injection, one, three, and six months. Results: N⫽60 patients. Fifty percent of the injection procedures were done in office and 50% in OR. Fifty-seven percent diagnosed with unilateral paralysis and 42% with glottal incompetence with mobile vocal folds. Patient satisfaction 6 months-post showed 56% had significantly improved voice and 38% reported moderately improved voice. Paired t-tests from baseline to 6 months showed significant improvements on the VHI and VAS (vocal effort), CAPE-V judgments of voice severity and videoendostroboscopy ratings of glottal closure, and objective voice measures of glottal closure (MPT and S-Z ratio). Conclusion: Preliminary results in this large cohort of patients demonstrate excellent clinical results. Significance: Data from one-month follow-up indicate that CaHA is a valuable injectable material for glottal incompetence.
Results: Thirty nine cases were identified. The microvascular flap survived in all but two of these cases. No significant donor site morbidity was noted in any of the patients. There was a need for flap revision with patient growth in two of these cases. Twenty five per cent of the pediatric microvascular experience involved defects that were not created for malignant disease. Conclusion: The use of microvascular free tissue transfer has an established and definite role in the reconstruction of head and neck defects in the pediatric population. While the reasons for creating these defects in children are often different from those in adults, the techniques, outcomes and complications are quite similar to those found in the adult population. 8:08
AM
Patterns of Care for Treatment of Laryngeal Cancer Amy Y Chen, MD MPH (presenter); Yongping Hao; Dana Flanders; Ahmedin Jemal; Andrew Stewart; Elizabeth Ward Atlanta GA; Atlanta GA; Atlanta GA; Atlanta GA; Chicago IL; Atlanta GA
Objectives: The aim of this study is to describe patterns of care of laryngeal cancer using the National Cancer Database,
WEDNESDAY
based tertiary referral center were involved in this retrospective study. These procedures were performed for various upper aerodigestive pathologies, including recurrent respiratory papillomatosis, chronic granulomas, and recurrent leukoplakia. Subjects were asked to rate their overall experience with the transnasal pulsed-dye laser treatment on a scale of 1-10. They were also asked specific questions about recovery time, pain medication, and preference of operating room versus in-office procedures. Results: The average tolerance score was seven (10 being minimal discomfort). Ninety percent did not use any pain medication. Eighty percent stated that, if possible, they would prefer to undergo unsedated in-office procedures rather than surgeries under general anesthesia for further treatment of their upper aerodigestive tract pathology. Conclusion: Unsedated transnasal treatment of upper aerodigestive tract pathology is readily accepted and welltolerated by otolaryngology patients.
Scientific Session—Wednesday P171
8:56
AM
Vocal Fold Augmentation with Calcium Hydroxylapatite (CaHA) Clark A Rosen, MD (presenter); Jackie Gartner-Schmidt, PhD; Timothy D Anderson, MD; Roy R Casiano, MD; Marc J Remacle, MD PhD; Lee A Reussner, MD; Robert T Sataloff, MD; Felicia L Johnson, MD
•
Scientific Session: Head and Neck Surgery LACC Room 408B Moderators: Eduardo M. Diaz, Jr., MD; B. Tucker Woodson, MD
8:00
AM
State of the Art in Pediatric Microvascular Reconstruction David Jack Arnold, MD (presenter); Mark K Wax, MD Miami FL; Portland OR
Objectives: To review the composite experience of the members of the microvascular committee and their respective institutions with respect to the treatment of pediatric patients using microvascular reconstructive techniques. Methods: All members of the committee were asked to review their institution’s cumulative experience with microvascular free flap reconstruction in the pediatric age group which was defined as age less than or equal to 21 years at the time of reconstruction. Specific data was collected and included: age at reconstruction, defect to be reconstructed, type of flap used, details of vascular anastamoses, donor site morbidity, flap viability, and need for flap revision.
Pittsburgh PA; Pittsburgh PA; Belmont MA; Miami FL; Yvoir Belgium; Lawrence KS; Philadelphia PA; Little Rock AR
Objectives: Evaluate the effectiveness of CaHA injection for patients with glottal incompetence. Methods: Multi-center, open-label, prospective clinical study with each patient serving as his/her own control. Voice related outcome measures were collected for pre-injection, one, three, and six months. Results: N⫽60 patients. Fifty percent of the injection procedures were done in office and 50% in OR. Fifty-seven percent diagnosed with unilateral paralysis and 42% with glottal incompetence with mobile vocal folds. Patient satisfaction 6 months-post showed 56% had significantly improved voice and 38% reported moderately improved voice. Paired t-tests from baseline to 6 months showed significant improvements on the VHI and VAS (vocal effort), CAPE-V judgments of voice severity and videoendostroboscopy ratings of glottal closure, and objective voice measures of glottal closure (MPT and S-Z ratio). Conclusion: Preliminary results in this large cohort of patients demonstrate excellent clinical results. Significance: Data from one-month follow-up indicate that CaHA is a valuable injectable material for glottal incompetence.
Results: Thirty nine cases were identified. The microvascular flap survived in all but two of these cases. No significant donor site morbidity was noted in any of the patients. There was a need for flap revision with patient growth in two of these cases. Twenty five per cent of the pediatric microvascular experience involved defects that were not created for malignant disease. Conclusion: The use of microvascular free tissue transfer has an established and definite role in the reconstruction of head and neck defects in the pediatric population. While the reasons for creating these defects in children are often different from those in adults, the techniques, outcomes and complications are quite similar to those found in the adult population. 8:08
AM
Patterns of Care for Treatment of Laryngeal Cancer Amy Y Chen, MD MPH (presenter); Yongping Hao; Dana Flanders; Ahmedin Jemal; Andrew Stewart; Elizabeth Ward Atlanta GA; Atlanta GA; Atlanta GA; Atlanta GA; Chicago IL; Atlanta GA
Objectives: The aim of this study is to describe patterns of care of laryngeal cancer using the National Cancer Database,
WEDNESDAY
based tertiary referral center were involved in this retrospective study. These procedures were performed for various upper aerodigestive pathologies, including recurrent respiratory papillomatosis, chronic granulomas, and recurrent leukoplakia. Subjects were asked to rate their overall experience with the transnasal pulsed-dye laser treatment on a scale of 1-10. They were also asked specific questions about recovery time, pain medication, and preference of operating room versus in-office procedures. Results: The average tolerance score was seven (10 being minimal discomfort). Ninety percent did not use any pain medication. Eighty percent stated that, if possible, they would prefer to undergo unsedated in-office procedures rather than surgeries under general anesthesia for further treatment of their upper aerodigestive tract pathology. Conclusion: Unsedated transnasal treatment of upper aerodigestive tract pathology is readily accepted and welltolerated by otolaryngology patients.
Scientific Session—Wednesday P171