Bioplastique™ medialization therapy improves the quality of life in terminally ill patients with vocal cord palsy

Unilateral vocal cord palsy can result in a weak breathy voice and an inability to communicate effectively. This study was designed to assess prospectively the efficacy of polymethylsiloxane elastomer (Bioplastique™) medialization injection therapy in patients with vocal cord palsy and terminal disease with particular regard to quality of life issues. Patients with unilateral vocal cord palsy secondary to malignant disease were offered Bioplastique™ injection. A digital voice recording was taken preoperatively and at 1 month, 3 months and 6 months postoperatively. Maximum phonation time (MPT) was recorded at the same intervals, and patients completed two questionnaires: the voice handicap index (VHI) and SF 36 general health questionnaire. Sixteen patients were entered into the study. There was a significant improvement in voice score, MPT, VHI and in three subgroups of the SF 36 at 1 month postoperatively, and the improvement was maintained in the small number who survived to 3 and 6 months. Bioplastique™ injection for unilateral vocal cord palsy produces a significant improvement in quality of life in addition to measured voice quality in patients with terminal disease. It should be recommended in patients even when the life expectancy is short.