الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Glottal insufficiency is a major clinical problem in every phoniatric practice. It results in glottal gap between the two vocal cords, which in turn might cause dysphonia, dysphagia and breathing problems. Vocal cord injection is considered a safe, reliable and highly effective method of treatment.
The present study included twenty consecutive patients (15 females and 5 males), their age ranged from 30-67 years. The cause of glottal insufficiency was unilateral vocal cord paralysis in 15 cases, unilateral VC atrophy in 2 cases, unilateral VC bowing in 1 case and bilateral sulcus vocalis in 1 case. VC injection with hyaluronic acid was performed in 19 patients under general anesthesia. One case was aborted due to extremely difficult exposure of the true vocal cord.
The aim of this study was to assess voice results in patients with glottal insufficiency after VC injection and amount of injection needed for a particular glottal gap. Assessment protocol was done pre-injection, two weeks, one month and 6 months after injection.
The results of the study revealed satisfactory statistically significant improvement of voice by perceptual assessment, measurement of glottal gap size and acoustic analysis.
The study group showed gradual improvement in voice quality after injection and better results were achieved after two weeks. Full stabilization of voice had occurred after 1 month, and this was statistically significant, as well as being noticeable to the patients themselves.
The best post-operative voice outcomes were noted in patients with unilateral vocal cord paralysis
Also the best results were obtained in cases with small to moderate phonatory gap
(1-2 mm) due to complete closure of the phonatory gap and approximation of the free edge of the affected vocal cord.
The added value of this study was evaluation of voice outcomes with full diagnostic protocol of voice disorders while most of other studies, authors assessed voice quality by using single diagnostic tools.
Another added value of this study was to determine the precise amount of hyaluronic acid appropriate for each gap.
One of the limitations in this study was small sample size, so the present study should be replicated with a larger sample. Also, the study focused on the short-term outcomes of VC injection in glottal insufficiency patients and further studies are needed to investigate its long-term outcome in these patients.