Vocal fold augmentation with calcium hydroxylapatite: twelve-month report

Laryngoscope. 2009 May;119(5):1033-41. doi: 10.1002/lary.20126.


Objectives: To evaluate the long-term effectiveness of calcium hydroxylapatite (CaHA) vocal fold injection for patients with glottal insufficiency.

Study design: Multicenter, open-label, prospective clinical study of CaHA vocal fold injection.

Methods: Each patient served as his/her own control. Voice-related outcome measures were collected for pre-injection, 1, 3, 6, and 12 months.

Results: Sixty-three patients were available for evaluation. Fifty-three percent of the injection procedures were done in the office. Fifty-seven percent of patients were diagnosed with unilateral paralysis and 43% with glottal incompetence with mobile vocal folds. Patient satisfaction 12 months after injection showed 67% reporting a significant improvement in voice and 81% reporting at least a moderate improvement in voice. Utilizing the Voice Handicap Index-10, visual analog scale (vocal effort), Consensus Assessment Perceptual Evaluation V (judgments of voice severity), and objective voice measures of glottal closure (maximum phonation time and S:Z ratio), paired t tests showed significant improvements after treatment. A 22% further treatment rate was found at the 12-month time point.

Conclusions: One-year results in this large cohort of patients with glottal incompetence treated with CaHA vocal fold injection demonstrate that excellent clinical results were achieved.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biocompatible Materials / administration & dosage
  • Biocompatible Materials / therapeutic use*
  • Durapatite / administration & dosage
  • Durapatite / therapeutic use*
  • Female
  • Humans
  • Injections
  • Linear Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Stroboscopy
  • Treatment Outcome
  • Vocal Cord Paralysis / drug therapy*
  • Vocal Cords / drug effects*


  • Biocompatible Materials
  • Durapatite