Prolaryn Gel Injection

[ainsley]

So, I had my VFS with Dr. Haben in Rochester last May.  I had a gap in the anterior portion of my vocal folds afterward that presented me with hoarseness, breathiness, and a lack of power.  This gap was not necessarily a direct surgery effect, but because I smoked for 17 years (quit in 1999), I am 49, and I had hoarseness before the surgery, the surgery just made this more pronounced since the webbing that took away my lower Hz also took away much of the folds that were touching.  That left me with just one small area that came together to create sound.  Here is the gap:



After the prolaryn inject last fri here is the picture:



No breathiness or hoarseness, and much more power.  My UHC insurance covered the injections.  The injection is a temporary solution and will need to be redone in several months.  There is a longer lasting one (prolaryn Plus, I believe) and it lasts a year or two.  My Dr. used the temp gel to see how mine reacted and gauge what to use in the long term injection that we will do next time, later this year.

I thought I would share this in case others have no idea about this solution, or if you have questions.  I am happy to answer.

[kwala]

Thanks for sharing. I've recently had a prolaryn gel injection as well. In my case, scarring is much more of a problem than incomplete closure, so while I did gain power/volume my hoarseness still remains unchanged. Glad this this worked for you.

[ainsley]

Thanks, Kwala.  I am sorry it was not the solution for you. 

I was not aware of it as an option.  Maybe I missed some posts of it here, and I did search for prolaryn with no results, so I was kind of excited when Dr. Haben told me there was hope.  I had my local ENT doctor do the injection, so I didn't have to travel to Rochester for it.   

[GeekGirl]

Thanks, Kwala.  I am sorry it was not the solution for you. 

I was not aware of it as an option.  Maybe I missed some posts of it here, and I did search for prolaryn with no results, so I was kind of excited when Dr. Haben told me there was hope.  I had my local ENT doctor do the injection, so I didn't have to travel to Rochester for it.

Hi ainsley,

Did you get the injection through the throat/neck or in through the mouth? I've read about both possibilities.

[kwala]

Hi ainsley,

Did you get the injection through the throat/neck or in through the mouth? I've read about both possibilities.

I can't answer for Ainsley but when I had it done they actually put me under and injected it through the mouth. It only took 15-20 minutes.

[ainsley]

Hi ainsley,

Did you get the injection through the throat/neck or in through the mouth? I've read about both possibilities.

They went through my mouth in the operating room under anesthesia.  It costs more that way, because of the hospital charges, but is easier for the Dr and the patient.  My insurance covered my injections.

[GeekGirl]

Hmmm.... I would try this. I think I'll get an ENT appointment once I see my PCP next month.

[ainsley]

Hmmm.... I would try this. I think I'll get an ENT appointment once I see my PCP next month.

Good luck and let me know how it goes.  I am interested.
I go in for followup injections in November of this year.  I will post info afterward.

[GeekGirl]

Hello my peeps!

So, as promised, I'd report back on my PCP appointment, which I had today. My PCP immediately recommended Dr. Natasha Mirza at Penn who specializes in "voice gender reassignment surgery." Ohhhh... kay.... now I'm wondering who this doctor is and what she knows about the subject. Does anyone have any experience with her? On her expertise list...

    Difficulty Swallowing (Dysphagia)
    Dry Mouth (Xerostomia)
    Endoscopic Laser Surgery
    Endoscopic Zenker's Diverticulum Repair
    Esophageal Dilation
    Esophageal Strictures
    Esophagitis
    Gastroesophageal Reflux Disease (GERD)
    Granulomatosis with Polyangiitis
    Hyperparathyroidism
    Hyperthyroidism (Overactive Thyroid)
    Independent Medical Exam (IME)
    Laryngeal Stenosis
    Laryngectomy (Laryngeal Surgery)
    Laryngoscopy
    Larynx Cancer
    Lesbian, Gay, Bisexual and Transgender Health (LGBT)
    Sarcoidosis
    Second Opinion
    Sjogren's Syndrome
    Therapeutic Endoscopy
    Vocal Cord Laser Surgery
    Vocal Cord Surgery
    Zenker's Diverticulum

and on a second expertise list:

Description of Clinical Expertise
Voice Disorders, including professional voice users
Spasmodic Dysphonia
Laryngeal diseases
Breathing dystonias
laryngeal diseases
Papillomatosis
Swallowing disorders
Office and Endoscopy suite procedures
Laser procedures
Botox injections
Taste and olfaction disorders

Aha, botox injections! I'm wondering now if this is the doctor here who might do Prolaryn as well. I guess only an appt will enable me to find out. It might be worth the $50 fee.

[ainsley]

Ok, so the prolaryn plus injection last fall did not last even a month and my ENT at the university of Missouri referred me to a guy at Washington university in st. louis.  He did injections without anesthesia through my neck while I was awake and phonating for him with Juvaderm last week.  Thus far it is the best result I have had to address the gap in my cords.  He said the gap is due to scar tissue directly in front of the webbing created by Dr. Haben and that is the sole cause of the hoarseness and lack of volume I have.  He said the only thing to permanently address the scar tissue is a(nother) glottoplasty to encompass that scarring.  So, it looks like that is up next for me.  My pitch in his office was 208 and he said the glottoplasty may raise that pitch a little, but it should remove the gap and increase my volume, give me a clear tone, and stop the hoarseness.

[Laurie]

Ok, so the prolaryn plus injection last fall did not last even a month and my ENT at the university of Missouri referred me to a guy at Washington university in st. louis.  He did injections without anesthesia through my neck while I was awake and phonating for him with Juvaderm last week.  Thus far it is the best result I have had to address the gap in my cords.  He said the gap is due to scar tissue directly in front of the webbing created by Dr. Haben and that is the sole cause of the hoarseness and lack of volume I have.  He said the only thing to permanently address the scar tissue is a(nother) glottoplasty to encompass that scarring.  So, it looks like that is up next for me.  My pitch in his office was 208 and he said the glottoplasty may raise that pitch a little, but it should remove the gap and increase my volume, give me a clear tone, and stop the hoarseness.

I just don't know about you Ainsley. I mean injection, glottoplasty glottoplasti whateva and tornados? Don't you ever get enough?  Good luck.

Hugs,
   Laurie

[ainsley]

I just don't know about you Ainsley. I mean injection, glottoplasty glottoplasti whateva and tornados? Don't you ever get enough?  Good luck.

Hugs,
   Laurie

Yup, I am a glutton for punishment!  Bring it!!    (btw, I just read there was a tornado in Missouri yesterday...)

[Laurie]

Yup, I am a glutton for punishment!  Bring it!!    (btw, I just read there was a tornado in Missouri yesterday...)

I heard there was a watch.

Sent from my LGL44VL using Tapatalk

[kwala]

Ok, so the prolaryn plus injection last fall did not last even a month and my ENT at the university of Missouri referred me to a guy at Washington university in st. louis.  He did injections without anesthesia through my neck while I was awake and phonating for him with Juvaderm last week.  Thus far it is the best result I have had to address the gap in my cords.  He said the gap is due to scar tissue directly in front of the webbing created by Dr. Haben and that is the sole cause of the hoarseness and lack of volume I have.  He said the only thing to permanently address the scar tissue is a(nother) glottoplasty to encompass that scarring.  So, it looks like that is up next for me.  My pitch in his office was 208 and he said the glottoplasty may raise that pitch a little, but it should remove the gap and increase my volume, give me a clear tone, and stop the hoarseness.

Thanks for the update. I hope they are able to resolve your issues!

[Colleen_definitely]

And they're doing it in Columbia?

I am curious about a long running issue that seems to plague my family.  We're all soft spoken, going back at least four generations.  My grandfather had a scope jammed into his throat since he had cancer and they found one vocal cord simply did nothing.  I'm curious if your doc can look into that for me and if they can do anything about it.  I can get great pitch, I just can't project and never could.

[ainsley]

And they're doing it in Columbia?

I am curious about a long running issue that seems to plague my family.  We're all soft spoken, going back at least four generations.  My grandfather had a scope jammed into his throat since he had cancer and they found one vocal cord simply did nothing.  I'm curious if your doc can look into that for me and if they can do anything about it.  I can get great pitch, I just can't project and never could.

My Columbia doc referred me to WashU

I think they would be a good place to start for something like you are describing.  They scoped me in the office on the first visit.  Addressing vocal cord issues is their specialty.  PM me if you want more deets on the Doctor I am seeing.

[ainsley]

So, the Juvaderm did not last any longer than the prolaryn gel/plus did.  At my two week follow-up I was sounding like I did before the injections: hoarse with poor tone and no volume.  Time for the glottoplasty.  My insurance pre-authorized it (yay!) and I will have it done next month.  The goal is to encompass the scar tissue that is directly in front of the webbing with the glottoplasty.  I have to spend the night in the hospital afterward because he is concerned about my airway, since it will be smaller after the surg.  I live two hours away from him, so since he lives 15 mins from the hospital he wants me to stay. lol  No talking for two weeks afterward.

[kwala]

So, the Juvaderm did not last any longer than the prolaryn gel/plus did.  At my two week follow-up I was sounding like I did before the injections: hoarse with poor tone and no volume.  Time for the glottoplasty.  My insurance pre-authorized it (yay!) and I will have it done next month.  The goal is to encompass the scar tissue that is directly in front of the webbing with the glottoplasty.  I have to spend the night in the hospital afterward because he is concerned about my airway, since it will be smaller after the surg.  I live two hours away from him, so since he lives 15 mins from the hospital he wants me to stay. lol  No talking for two weeks afterward.

Thanks for continuing to update. While not entirely the same situation, I am also undergoing a procedure to work around scar tissue from my previous vocal web surgery. Hope it works out, I'll be following your updates!

[ainsley]

Thanks for continuing to update. While not entirely the same situation, I am also undergoing a procedure to work around scar tissue from my previous vocal web surgery. Hope it works out, I'll be following your updates!

Oh, well I am happy to hear you have an option to deal with your issue, too!!  I hope it works for you....I know you have struggled like I have.  I look forward to hearing your results, too.

[nongcandy8558]

If you want it to last longer, I think fat injection will help, it can last up to 2 years