Fat augmentation for glottic insufficiency.
OBJECTIVE
Fat lipoinjection augmentation for glottic insufficiency has been used in patients with vocal fold paralysis. Relatively little information is available on the effectiveness of fat injection in patients with vocal atrophy, intubation trauma, and post-hemilaryngectomy defects.


METHODS
This paper retrospectively compares the efficiency of fat injection in patients with vocal cord paralysis (n = 9), vocal scar (n = 13), and vocal atrophy (n = 11).


METHODS
The perceptual acoustic, phonatory function, and videolaryngostroboscopic data were evaluated before and after fat augmentation in 33 patients.


RESULTS
Mean follow-up time was 9.7 months. Nineteen patients had excellent results. Three patients had no change. Five patients had late failure. Six patients were lost to follow-up. Phonatory function showed significant improvement in jitter, shimmer, noise-to-harmonic ratio, maximal phonation time, grade, asthenia, and breathiness (P < .05). Videolaryngostroboscopic rating showed significant improvement in right linearity of the vocal fold edge, amplitude of vocal fold vibration, excursion of the mucosal wave, vibratory behavior, and phase symmetry (P < .05). Anterior defects did better than posterior defects. Small vocal fold defects did better than large defects.


CONCLUSIONS
Fat injection is a good autogenous implant and may be considered as an option in management of patients with vocal fold scar, defect, or atrophy. Reabsorption of fat is a problem, but the procedure may be repeated.
Hsiung
M W
MW
Department of Otolaryngology--Head and Neck Surgery, The Mount Sinai Hospital, The Grabscheid Voice Center, New York, New York 10029-6574, USA.
Woo
P
P
Minasian
A
A
Schaefer Mojica
J
J
D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007267:Injections; D007818:Laryngeal Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure; D014826:Vocal Cord Paralysis / Q000150:complications / Q000601:surgery; D014827:Vocal Cords / Q000473:pathology; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology / Q000601:surgery