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.
Sources
1. Bergamini, G., Alicandri - Ciufelli, M., Molteni, G., Villari, D., Luppi, M. P., Genovese, E., Presutti, L.: Therapy of unilateral vocal fold paralysis with polydimethylsiloxane injection laryngoplasty: our experience. J. of Voice, 24, 2010, s. 119-125.
2. Cantarella, G., Mazzola, R. F., Domenichini, E., Arnone, F., Maraschi, B.: Vocal fold augmentation by autologous fat injection with lipostructure procedure. Otolaryngol. Head Neck Surg., 132, 2005, s. 239-243.
3. De Souza Kruschewsky, L., De Mello-Filho, F. V., Saggioro, F., Serafini, L. N., Rosen, C. A.: Histologic study of an autologous fat graft in the larynx of dogs with unilateral vocal fold paralysis. Laryngoscope, 117, 2007, s. 2045-2049.
4. Ford, Ch. N., Bless, D. M.: Phonosurgery, assessment and surgical management of voice disorders. Raven Press, New York, 1991, s. 244.
5. Friedrich, G., Remacle, M., Birchall, M., Marie, J. P., Arens, Ch.: Defining phonosurgery: a proposal for classification and nomenclature by the Phonosurgery Committee of the European Laryngological Society (ELS). Eur Arch. Otorhinolaryngol., 264, 2007, s. 1191-1200.
6. Gould, W. J., Sataloff, R. T., Spiegel, J. R.: Voice surgery. Mosby, St. Louis, 1993, s. 367.
7. Grillone, G. A.: Phonosurgery. Otolaryngol. Clin. N. Am. Saunders, Philadelphia, 2006, s. 228.
8. Guven, M, Suoglu, Y., Kiyak, E., Demir, D.: Autologous fat augmentation for voice and swallow improvement after cordectomy. ORL J. Otorhinolaryngol. Relat. Spec., 63, 2006, s. 164-169.
9. Hsiung, M. W., Lin, Y. S., Su, W. F., Wang, H. W.: Autogenous fat injection for vocal fold atrophy. Eur Arch. Otorhinolaryngol., 260, 2003, s. 469-474.
10. Cheng, Y., Li, Z. Q., Huang, J. Z., Xue, F., Jiang, M. J., Wu, K. M., Wang, Q. P.: Combination of autologous fascia lata and fat injection into the vocal fold via the cricothyroid gap for unilateral vocal fold paralysis. Arch. Otolaryngol. Head Neck Surg., 135, 2009, s. 759-763.
11. Lorenc, B.: Možnosti chirurgickej liečby jednostrannej paralýzy hlasivky. Atestačná práca, Foniatrické oddelenie FN Bratislava a I. ORL klinika FN, LF UK a SZU Bratislava, 2007, s. 90.
12. Mallur, P. S., Rosen, C. A.: Vocal fold injection: review of Indications, techniques, and materials for augmentation. Clinical and Experimental Otorhinolaryngology, 3, 2010, s. 177-182.
13. Mochizuki, R., Muta, H., Watanabe, Y., Kavamoto, M., Yamamoto, K.: ocal fold injection with autologous fat as surgical management of laryngeal granulomas non-responsive to first-line treatments. J. Japan Broncho - Esophagolog Soc., 58, 2007, s. 30-37.
14. Nakamura, M., Tokashiki, R., Issiki, N., Hiramatu, H., Kanazawa, H., Motohashi, R., Suzuki, M.: Over-injection of autologous fat in the vocal fold: how to remove the excess? Eur Arch. Otorhinolaryngol., 266, 2009, s. 1589-1593.
15. Perretti, G., Bolzoni, A., Piazza, C.: Primary intracordal autologous fat injection (PIAFI ) after endoscopic cordectomies for glottic cancer: a new phonosurgical concept. Storz EndoWorld, 72, 2007, s. 7.
16. Profant, M., Lorenc, B.: Medializácia ochrnutej hlasivky titánovým implantátom. Choroby hlavy a krku, 2, 2006, s. 25-32.
17. Rosen, C. A., Simpson, B. C.: Operative techniques in laryngology. Springer-Verlag, Berlin Heidelberg, 2008, s. 312.
18. Rosen, C. A., Thekdi, A. A.: Vocald fold augmentation with injectable Calcium Hydroxylapatite: short - term results. Journal of Voice, 44, 2004, s. 234-243.
19. Sanderson, J. D., Simpson, C. B.: Laryngeal complications after lipoinjection for vocal fold augmentation. Laryngoscope , 119, 2009, s. 1652-1657.
20. Sasai, H., Watanabe, Y., Muta, H., Yoshida, J., Hayashi, I., Ogawa, M., Kubo, T.: Long-term histological outcomes of injected autologous fat into human vocal folds after secondary laryngectomy. Otolaryngol. Head Neck Surg., 132, 2005, s. 685-688.
21. Sato, K., Umeno, H., Nakashima, T.: Autologous fat injection laryngohypopharyngoplasty for aspiration after vocal fold paralysis. Ann. Otol. Rhinol. Laryngol., 113, 2004, s. 87-92.
22. Sittel, Ch., Echternach, M., Federpsil, P. A., Plinkert, P. K.: Polydimethylsiloxane particles for permanent injection laryngoplasty. Ann. Otol. Rhinol. Laryngol., 115, 2006, s. 103-109.
23. Tamura, E., kada, S., hibuya, M., Iida, M.: Comparison of fat tissues used in intracordal autologous fat injection. Acta Oto-Laryngologica, 130, 010, s. 405-409.
24. Tedla, M. et al.: Poruchy polykání. Medicína hlavy a rku. Tobiáš, Havlíčkôv Brod, 2009, s. 312.
25. Umeno, H., Chitose, S., Sato, K., Nakashima, T.: Comparative study of framework surgery and fat injection laryngoplasty. J. Laryngol. Otol. Suppl., 31, 2009, s. 35-41.
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
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