Vocal fold augmentation by injection of autologous fascia.
Vocal fold augmentation by injection under direct visual control is a quick and simple operation. However, when autologous fat or bovine collagen is used, resorption creates a problem. The low metabolic requirements and the relatively stable histologic character of free fascial grafts make autologous fascia a fascinating material in vocal fold augmentation. This research project was carried out to establish a suitable method to transplant fascia into a vocal fold and to assess its impact on the voice. A piece of fascia lata was chopped with a scalpel. The material was injected in the lateral aspect of the thyroarytenoid muscle using a pressure syringe. Nine subjects with a paralyzed vocal fold were analyzed after the injection. The postoperative voice, rated by a panel of experienced listeners, was significantly better than the preoperative (P < 0.05). Five of nine voices were rated normal or near normal after the procedure. The mean maximal phonation time increased significantly (P < 0.01). All patients considered that their voice had improved, and eight of nine regarded it as good. No one reported deterioration of the result during the follow-up (mean duration, 10 months; range, 3 to 18 months).
Rihkanen
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D000368:Aged; D000369:Aged, 80 and over; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014182:Transplantation, Autologous / Q000379:methods; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014827:Vocal Cords / Q000601:surgery*