Guy’s and St Thomas’ first in the UK to help man find his voice with new regenerative treatment

Guy’s and St Thomas’ has become the first NHS trust in the UK to offer a “life-changing” treatment for people with chronic voice disorders.

The use of Platelet-Rich Plasma (PRP) injections involves taking a small sample of the patient’s blood and spinning it in a centrifuge machine to concentrate and separate the platelet-rich plasma. This concentrated solution is then injected into the patient’s vocal cords – also known as vocal folds – to boost the natural healing process, shorten recovery time and promote tissue regeneration.

The treatment is already used in a variety of conditions for people with injuries to their tendons, ligaments, muscles and joints, as well as for osteoarthritis, and cosmetic purposes such as hair loss and skin rejuvenation. 

Guy’s and St Thomas’ is the first NHS trust in the country to provide this treatment in the larynx (or voice box) for patients with voice change due to vocal fold atrophy or thinning (commonly age-related), vocal fold scarring, and sulcus vocalis. These conditions cause voice change or dysphonia, making the voice sound hoarse, strained, breathy, weak, or fluctuate in pitch and loudness.

David Metherell, from Catford in south east London, was one of the first patients to benefit from the new treatment at Guy’s Hospital. He caught a rare strain of the human papillomavirus (HPV) as a baby, causing him to develop recurrent respiratory papillomatosis, which are wart-like growths, to his voice box. He had surgery to remove them, but they returned – between the ages of 9 months and 6 years old it recurred 21 times resulting in him having repeated laser and debulking treatment.

David, a critical care charge nurse, said: “Doctors told my parents that the damage to my voice box was so severe they were considering a permanent tracheostomy but thankfully the last procedure worked. 

“I was a kid with a croaky voice and went through school sounding different to everyone else. I would never sing in assembly and would just lip sync. It was tough because children mimic you or make up stories about you, like I’d swallowed a penny.”

The 44-year-old added: “The biggest frustration for me is I can’t meet anyone new without people asking if I have a sore throat. You feel like you have to explain yourself over and over again which is exhausting.”

During the COVID-19 pandemic, David managed an intensive care unit at St Thomas’ Hospital and saw his voice decline over 2 years.

He said: “I had to project my voice through a mask, full PPE and the hum of the ventilators. When I was speaking my voice would suddenly stop, like someone had put their hand over my mouth.”

David was referred to the ENT voice clinic at Guy’s Hospital where he was given exercises by speech and language therapists. He also received injection laryngoplasty, which involves injecting a temporary filler (hyaluronic acid) into the scarred vocal cords to plump them up so they can meet in the middle to produce voice.

David said: “Although these things helped my voice it didn’t last long. So when I was offered the chance to join a trial for PRP injections I jumped at the chance – it seemed like a no brainer because it was using my own blood cells so my body wouldn’t reject the treatment.”

The father-of-one had the injection in clinic under local anaesthetic and was then under voice rest for the next 48 hours. He had the treatment three times in total, 4 weeks apart.
 
David said: “I noticed a difference in my voice after the first 4 weeks. For me it wasn’t about the quality of my voice as I’ve had a husky voice my entire life. It was about the effort it takes to talk. For anyone with a normal voice box speaking is really easy. But if your vocal cords don’t meet when speaking, the effort to get a voice out is really tiring.

“After the second treatment it felt brilliant and I could speak with hardly any effort – it’s been really impressive, the treatment is life changing.”

David’s colleagues have noticed a change in his voice, but it’s his 4-year-old son who has seen the biggest difference.

David said: “He loves Julia Donaldson books so now I can do a detailed voice for all the different characters, which he absolutely loves. He also says he enjoys daddy singing a little bit more.”

Shiying Hey, a consultant ENT surgeon and laryngologist at Guy’s and St Thomas’, set up the PRP injection trial in August 2025. So far, together with her colleagues, their team has treated 10 patients, with all of them reporting an improvement in their voice.

Shiying said: “Not having a good voice can have a huge impact on someone’s life, as they can feel like they’re losing their identity. This new regenerative treatment option for people with chronic voice disorders can help improve dysphonia and vocal functions. 

“It is usually performed in our clinic with state-of-the-art facilities, allowing quicker treatment and avoiding the need for a general anaesthesia. It is also cheaper than current treatments as we use the patient’s own blood, and it can be longer lasting as the PRP encourages the vocal cords to regenerate and accelerates the healing process. 

“It is incredibly exciting to be able to offer this treatment at our centre and to broaden the options available for people living with chronic voice disorders."

The ENT laryngology clinic at Guy’s and St Thomas’ is only accepting referrals for the treatment from GPs and health professionals.

People who will be considered for the treatment are those with mild, moderate, or severe dysphonia affecting daily or professional voice use due to:

• Presbyphonia or vocal fold atrophy, or
• Vocal fold scarring, or
• Sulcus vocalis