Supplementary Material for: In-Office Hyaluronate Injection Laryngoplasty as Palliative Treatment for Unilateral Vocal Fold Paralysis

<b><i>Background:</i></b> Voice and swallowing impairments can impact on both quality of life and survival. Unilateral vocal fold paralysis (UVFP) as a result of distant metastasis can cause breathy voice and aspiration. The purpose of this study is to develop and evaluate a less invasive and effective alternative therapy for UVFP. <b><i>Methods:</i></b> This was a retrospective review of prospectively enrolled patients at a tertiary referral center in Taiwan. Among a cohort of 177 patients who received intracordal hyaluronate injections, 2 had UVFP from distant metastasis and met the inclusion criteria. Vocal cord motion was recorded by videostroboscopy, and the normalized glottal gap area was measured. Voice quality, defined by speech language pathologists, and swallowing status were compared, and immediate complications after the injection were investigated. <b><i>Results:</i></b> Two patients with UVFP with M1 lesions (both lung) accepted the procedure. The glottal gap area was significantly improved 1 month after in-office hyaluronate injection. Voice quality and aspiration were also improved. No immediate complications were noted in either patient. <b><i>Conclusions:</i></b> In-office intracordal hyaluronate injection is a safe and effective treatment for UVFP, providing a palliative method to help maintain the patient's voice and quality of life.

**背景**：嗓音与吞咽功能障碍可同时对患者的生活质量及生存预后造成负面影响。由远处转移引发的单侧声带麻痹（Unilateral Vocal Fold Paralysis, UVFP）可导致气息样嗓音与误吸。本研究旨在开发并评估一种针对UVFP的低侵入性、高效替代治疗方案。
**方法**：本研究为一项回顾性分析，研究对象为中国台湾某三级转诊中心前瞻性入组的患者。在177例接受声带内透明质酸注射的患者队列中，有2例患者的UVFP由远处转移引发，且符合纳入标准。研究通过视频频闪喉镜记录声带运动状态，并测量归一化声门裂面积。由言语语言病理学家评定的嗓音质量与吞咽状态被纳入对比分析，同时对注射术后的即刻并发症进行了观察研究。
**结果**：2例合并M1期转移病灶（均为肺部转移）的UVFP患者接受了该治疗操作。门诊透明质酸注射术后1个月，患者的声门裂面积得到显著改善，嗓音质量与误吸情况均有所好转，且2例患者均未出现即刻并发症。
**结论**：门诊声带内透明质酸注射术是一种安全且有效的UVFP治疗手段，可为患者提供姑息性治疗方案，有助于维持患者的嗓音功能与生活质量。