{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T01:36:07Z","timestamp":1793064967751,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":4246,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2004,10]]},"abstract":"<jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Voice disorders affect more than 3% of the general population. Vocal fold atrophy is a part of the normal aging process, with up to 60% of 60\u2010year\u2010old individuals displaying evidence of glottal insufficiency. A safe, effective, and durable substance for injection augmentation of the vocal folds is not currently available. The purpose of this investigation was to describe our preliminary experience with calcium hydroxylapatite (CaHA) for vocal fold augmentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODOLOGY<\/jats:title><jats:p>All patients undergoing injection augmentation of the vocal folds with CaHA between January 1, 2002 and June 1, 2003 were pro\u2010spectively evaluated. Data concerning indications, technique, functional outcome, and complications were collected. In addition, the larynx donated from a woman who underwent vocal fold augmentation with CaHA and subsequently died from terminal cancer was histologically examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 39 vocal folds in 23\u00a0individuals were injected with CaHA. The mean age of the cohort was 62. Fifty\u2010two percent were male. The indications for augmentation were unilateral vocal fold paralysis (9\/23), unilateral vocal fold paresis (5\/23), presbylarynx (3\/23), Parkinson's (3\/23), bilateral vocal fold paresis (2\/23), and abductor spasmodic dysphonia (1\/20). There were no adverse reactions. All individuals reported improvement on a self\u2010administered disease\u2010specific outcome measure (<jats:italic>P<\/jats:italic> &lt; 0.001). The pathology from the donated larynx 3\u00a0months after injection revealed intact CaHA spherules in good position with a minimal, monocellular inflammatory reaction to the gel carrier and no evidence of implant rejection.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Initial experience with vocal fold augmentation using CaHA is promising. Long\u2010term safety and efficacy needs to be established.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2004.03.025","type":"journal-article","created":{"date-parts":[[2004,10,12]],"date-time":"2004-10-12T12:41:28Z","timestamp":1097584888000},"page":"351-354","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":90,"title":["Vocal Fold Augmentation with Calcium Hydroxylapatite"],"prefix":"10.1002","volume":"131","author":[{"given":"Peter C.","family":"Belafsky","sequence":"first","affiliation":[{"name":"Department of Otolaryngology UC Davis Medical Center Sacramento CA"},{"name":"The Center for Voice and Swallowing Disorders of Wake Forest University Winston\u2010Salem NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory N.","family":"Postma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology UC Davis Medical Center Sacramento CA"},{"name":"The Center for Voice and Swallowing Disorders of Wake Forest University Winston\u2010Salem NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1980.00790270013003"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.114256"},{"key":"e_1_2_6_4_1","first-page":"151","article-title":"Uber eine neue behandlungsmethode der rekurrenslahmung","volume":"18","author":"Brunings W","year":"1911","journal-title":"Verh Ver Laryngol"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199908000-00020"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1995.01890010092017"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949210100307"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199801000-00010"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200105000-00002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197808000-00007"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199205000-00005"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949810700901"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949510400702"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989310900318"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310200601"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200303000-00027"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311201103"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200012000-00006"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198106000-00037"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199290020-00003"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1991.01870160033004"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1991.01870160039005"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0011-8532(22)02093-6"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198805000-00003"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2004.03.025","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.otohns.2004.03.025","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2004.03.025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:02:38Z","timestamp":1760965358000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.otohns.2004.03.025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,10]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2004,10]]}},"alternative-id":["10.1016\/j.otohns.2004.03.025"],"URL":"https:\/\/doi.org\/10.1016\/j.otohns.2004.03.025","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,10]]},"assertion":[{"value":"2016-05-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}