Structural Fat Grafting to Improve Outcomes of Vocal Folds’ Fat Augmentation: Long-term Results

Objective Evaluating the long-term outcomes of vocal fold structural fat grafting. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Seventy-nine dysphonic patients (16-82 years; 55 with unilateral laryngeal paralysis and 24 with vocal fold scarring) under...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2018-01, Vol.158 (1), p.135-143
Main Authors: Cantarella, Giovanna, Mazzola, Riccardo F., Gaffuri, Michele, Iofrida, Elisabetta, Biondetti, Pietro, Forzenigo, Laura V., Pignataro, Lorenzo, Torretta, Sara
Format: Article
Language:English
Subjects:
Adipose Tissue - transplantation
Adolescent
Adult
Aged
Aged, 80 and over
Disability Evaluation
dysphonia
Dysphonia - surgery
Female
glottic incompetence
Humans
Magnetic Resonance Imaging
Male
Middle Aged
structural fat grafting
Tomography, X-Ray Computed
Treatment Outcome
Vocal Cords - surgery
vocal fold paralysis
vocal fold scarring
Voice Quality
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Summary:Objective Evaluating the long-term outcomes of vocal fold structural fat grafting. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Seventy-nine dysphonic patients (16-82 years; 55 with unilateral laryngeal paralysis and 24 with vocal fold scarring) underwent vocal fold fat injection. Fat was harvested by low-pressure liposuction and then processed by centrifugation. Refined fat aliquots were placed in the vocal fold and paraglottic space in multiple tunnels to enhance graft neovascularization. All patients were followed for 12 months, 15 for 3 years, and 5 for 10 years with videolaryngostroboscopy, maximal phonation time (MPT) measurement, Voice Handicap Index (VHI) questionnaire, and GRBAS (grade, roughness, breathiness, asthenia, strain) perceptual evaluation. Laryngeal computed tomography (CT) and/or magnetic resonance imaging (MRI) studies were performed in 16 patients 3 to 28 months postoperatively; MRI was repeated in 5 cases 12 to 18 months after the first radiological study. Results The voice quality of all patients improved after surgery, and long-term stability was confirmed by MPT, GRBAS, and VHI (P ranging between .004 and
ISSN:0194-5998
1097-6817
DOI:10.1177/0194599817739256