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Vocal Fold Augmentation by Autologous Fat – First Experience and Preliminary Results


Authors: B. Lorenc 1;  K. Abadl 2;  M. Karovičová 3;  Miroslav Tedla 4
Authors‘ workplace: ORL a Foniatrická ambulancia Pro Care, a. s., Bratislava 1;  ORL oddelenie Nemocnice sv. Michala, Bratislava 2;  Ambulancia plastickej chirurgie Pro Care a. s., Bratislava 3;  I. ORL klinika LF UK a UNB, Bratislava 4
Published in: Otorinolaryngol Foniatr, 60, 2011, No. 4, pp. 211-216.
Category: Original Article

Overview

Introduction:
True vocal fold injections are minimal invasive procedures and can be used for treatment of incomplete vocal fold closure. Injections are also used to correct vibrant mucosal deficiency of vocal fold or deliver medications to laryngeal tissues. One of the excellent materials in current use for vocal fold injection is autologous fat.

Aim:
We introduce preliminary clinical experience with endolaryngeal augmentation by autologous fat.

Material and methods:
Three patients with glottic insufficiency and/or  vibrant mucosal deficiency of vocal fold underwent the procedure. Their own fat was harvested and used in all patients. Autologous fat was injected by Peretti - Bolzoni High Pressure Syringe. Patients were examined before and after surgery in the phoniatry outpatient office. Both voice and laryngoscopic findings were evaluated by subjective and objective methods.

Results:
All three patients observed improvement of their voice. We confirmed improvement of glottic insufficiency, extending of maximum phonation time (MPT), moderate asthenia, reduction of breathy voice and diminish aspiration. More effective cough, significant  improvement linearity of vocal fold edge and vibrant behavior was also observed.

Conclusion:
Autologous fat is relative cheap biocompatible material with excellent viscosity and minimal hypersensitivity. It can be used for both temporary and long term augmentation of vocal folds. Reinjection is possible if necessary. This procedure can play important role in the field of phonosurgery in our countries although the exact augmenting effect is often difficult to predict.

Key words:
incomplete vocal fold closure, augmentation, autologous fat, voice assessment.


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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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