Introduction:Several recent systematic reviews have investigated treatment for dysphagia, a more prevalent problem among the elderly that increases risk of malnutrition, dehydration, and aspiration. Our goal was to determine if injection medialization laryngoplasty (IML) for presbylarynx improved dysphagia.
Methods: Patients over age 60 with vocal fold atrophy who received IML were identified through a retrospective review. Information extracted included diagnosis, demographics, procedure and follow-up dates, injection material, volume, approach, and pre- and post-procedure EAT-10, RSI, CSI, and VHI-10 scores. Patients were excluded if they had laryngeal pathology other than presbylarynx.
Results: 97 patients were identified. Of these, 71 initially reported dysphagia (EAT-10 ≥ 3). 43 of 71 reported improvement in swallowing of 6.8 points (95% CI, ±2.9) (pre-EAT-10 17.3 to post- 10.5, p=5.02e-12). 13 of these patients reported a post-EAT-10 <3. These 43 patients also reported improvements in RSI and VHI-10 (p=0.0003, p=0.032). 40 with CSI scores (p=6.9e-6) also improved. Of 26 patients without baseline dysphagia, 9 reported increased difficulty swallowing, though only 5 increased to ≥ 3 without significant changes in RSI, VHI-10, or CSI scores. The average change in EAT-10 for all patients was -1.25 (95% CI, ±1.34) with an average follow up of 31 days (95% CI, ± 3 days). 34 patients repeated the procedure with an average of 3 (95% CI, ±0.42) procedures.
Conclusions: Injection medialization laryngoplasty improved EAT-10 outcomes in elderly patients with vocal fold atrophy and dysphagia. Nearly a third of these patients reported resolution of dysphagia within a month of the procedure.