Direct from the UCLA Web page - Information about their
collagen injections procedure to aid those Parkies having
weak voices. The phone number listed on the site is
(310) 825-2023. I've found ya usually get voice mail unless
ya call close to 5 p.m. PST at this number as it's Dr. Burke's
nurse's phone - She's ALWAYS busy! The Head & Neck
Clinic's lobby phone number's (310) 206-6688.
Barb Mallut (who has had this beneficial procedure)
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Many people with neurologic disorders such as Parkinson's disease develop
weak, breathy voices that are not loud enough to be heard
or understood. Efforts to overcome this weakness by talking loudly
or shouting may lead to rapid fatigue in the speaker. Patients who
lose the use of their voice may feel they have lost their identity.
They often have difficulty talking on the telephone or performing a
job. Such patients can become isolated as they are forced to
withdraw from work and society.
Vocal weakness in patients with neuromuscular disorders (including Parkinson's
disease) usually occurs because the two vocal folds
(also called the vocal cords) do not meet completely during the
vibration that produces sound. Often the vocal folds of these patients
demonstrate a bowed appearance. When the vocal folds do not close tightly
during speech, efficient voice production cannot occur.
Augmentation of the vocal folds with collagen can successfully
restore the voice to a more normal loudness level, by helping the
vocal folds close more completely during vibration. Until recently,
people with Parkinson's disease were poor candidates for voice augmentation,
because prevailing techniques required general
anesthesia or open surgical operations, which are risky for such
patients. A new approach has been pioneered by Dr. Gerald S. Berke
of the Division of Head and Neck Surgery at UCLA. In this new procedure,
collagen is injected through the neck into the vocal folds.
This augmentation procedure is performed on an outpatient basis,
and does not require general anesthesia.
How the Procedure Works
Patients are first assessed in the UCLA Center for Voice in
Medicine and the Arts to determine their candidacy for the
procedure. During this assessment, the patient's larynx is
visualized with a stroboscope, a sample of voice and speech
is recorded, and aspects of laryngeal air flow and pressure
are studied. Those who are most helped by this procedure
have a weak voice resulting primarily from incomplete vocal
fold closure during vibration, but can pronounce words clearly
and are not hard to understand. Patients who are good
candidates for the procedure are given a test dose of collagen
to screen for sensitivity.
About four weeks after the initial screening, the procedure is
performed in the doctor's office. It takes about 15 minutes to
complete. First, the nurse sprays a local anesthetic in the nostril
to reduce any possible irritation. No other anesthetic is required.
A thin flexible tube is then inserted through the nose to see down
the throat. The doctor now injects a small amount of collagen
through the front of the neck and into the vocal folds. The injection
is guided by pictures of the vocal folds on a video monitor, and
is made with a small syringe like the ones used to administer a flu
shot. The injected collagen gently pushes the vocal cords toward
each other to correct for the bowing and produce a stronger voice.
This procedure is very well tolerated, and has been successfully
performed on adolescent and geriatric patients. Normally, a
patient can leave the clinic immediately after the procedure and
drive a car if desired. Results are noticed within one to two days.
The effects of the procedure, which uses bovine collagen, last for
about three to six months. The procedure may be repeated if
necessary. Autogenous collagen may also be harvested from the
patients themselves. This collagen may last longer. To date,
Dr. Berke has performed this procedure more than 250 times.
No medical complications of the procedure have been noted to
date. Most patients have achieved excellent results, although
patients with prominent vocal tremors have had more variable
results than patients without vocal tremors.
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