Efficacy of Autologous Platelet-Rich Plasma (PRP) Injections in the Management of Presbyphonia.

OBJECTIVES

To evaluate the clinical, auditory-perceptual, aerodynamic, and acoustic outcomes of serial autologous Platelet-Rich Plasma (PRP) injections administered via an in-office approach in a cohort of patients with presbyphonia.

METHODS

A single-center retrospective analysis was conducted on 36 patients (mean age 72.78 years) diagnosed with presbyphonia who underwent two to three serial PRP injections into the thyroarytenoid muscle between October 2021 and April 2025. Pre and post treatment evaluations included patient self-assessment via a 0-10 Visual Analog Scale for vocal handicap, auditory-perceptual analysis using the GRB scale, Maximum Phonation Time (MPT), acoustic parameters (F0, Jitter, HNR), and stroboscopic mucosal wave grading.

RESULTS

Thirty-five patients completed the primary protocol. Patient self-assessment scores demonstrated a highly significant reduction in perceived vocal handicap post-intervention (from 7.17 to 4.57, P < 0.0001, r = 0.584). Auditory-perceptual analysis revealed significant improvements across all GRB scale components, notably the overall Grade (P = 0.0002) and Roughness (P < 0.0001). MPT significantly increased from 11.47 to 13.31 seconds (P = 0.018). Conversely, traditional objective acoustic parameters showed no statistically significant post-treatment changes. Stroboscopic evaluation demonstrated improved mucosal wave dynamics in 82.9% of patients, which strongly correlated with self-assessment gains (ρ = 0.496, P = 0.0024). Baseline severity was a significant predictor of treatment response.

CONCLUSIONS

Serial office-based autologous PRP injections offer a safe, well-tolerated, and effective biological treatment for presbyphonia. By improving mucosal pliability and reducing perceived vocal handicap, PRP bridges the gap between conservative therapy and invasive surgical interventions, serving as a valuable regenerative tool for the aging voice.