title: Vocal fold augmentation by autologous fat injection with lipostructure procedure.
abstract: BACKGROUND
  Fat is theoretically the ideal implant for vocal fold augmentation because it is soft, easily available and biocompatible. However, reabsorption is a frequent cause of long-term failure.
  
  
  OBJECTIVE
  We prospectively tested Coleman's "lipostructure" technique used for facial recontouring in the treatment of glottic incompetence.
  
  
  METHODS
  Fourteen patients (aged 18-74 years, mean 48) with breathy dysphonia secondary to laryngeal hemiplegia (7) or anatomical defects (7) underwent vocal fold lipoinjection. Fat harvested by liposuction was centrifuged, and the fat cell layer injected into the vocalis muscle. The patients underwent pre- and postoperative videolaryngostroboscopy, maximum phonation time (MPT) measurements, GRBAS perceptual evaluations, and Voice Handicap Index (VHI) self-assessments.
  
  
  RESULTS
  Voice quality improved soon after surgery and remained stable over 3-26 months (mean 10.6), being confirmed by the GRBAS, MPT and VHI evaluations ( P < 0.005). The results were best in the seven patients with paralytic dysphonia.
  
  
  CONCLUSIONS
  Lipostructure is a valuable technique for voice rehabilitation in glottic incompetence.
authors.affiliation: Department of Otolaryngology, University of Milan and Ospedale Maggiore di Milano, IRCCS, Italy. giovanna.cantarella@policlinico.mi.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Cantarella
authors.forename: Riccardo F
authors.initials: RF
authors.lastname: Mazzola
authors.forename: Elena
authors.initials: E
authors.lastname: Domenichini
authors.forename: Flavio
authors.initials: F
authors.lastname: Arnone
authors.forename: Barbara
authors.initials: B
authors.lastname: Maraschi
mesh_terms: D017667:Adipocytes / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D049489:Stroboscopy; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014832:Voice Disorders / Q000601:surgery*; D014833:Voice Quality