Autologous transplantation of fascia into the vocal fold: long-term result of type-1 transplantation and the future.
OBJECTIVE
Since 1997, we have performed the autologous transplantation of fascia into the vocal fold (ATFV) procedure on cases of sulcus vocalis. In what follows, we report the long-term results of our new surgical approach and discuss the role of these transplantations. We also review and report some complications that can be caused by ATFV. Finally, we discuss the ATFV technique as a contribution to the phonosurgery of the future.


METHODS
Prospective study.


METHODS
We were able to obtain long-term results from 10 volunteer cases (2 female and 8 male, age: 15-71, mean 46.5 years old) who could be followed up for at least 3 years after transplantation. All were cases of pathologic sulcus vocalis.We measured maximum phonation time (MPT) and carried out pre- and postsurgical clinical observation and laryngeal stroboscopy in all cases. These measurements and observations were made before the ATFV and at 6 months, 1 year, 2 years, and 3 years after surgery.


RESULTS
In stroboscopic observation 1 year after the ATFV, satisfactory glottal closure and excellent mucosal wave were observed for all cases, and there was no case with hyperadduction of the false vocal folds. MPT measures remained at an improved level 2 years and 3 years after the transplantations. Paired-sample t tests showed that the improvement relative to preATFV levels was significant for all postsurgical measurements up to 3 years.


CONCLUSIONS
We conclude that ATFV is a successful surgical procedure for sulcus vocalis and scarred vocal folds. Other phonosurgical clinical applications may also be envisioned.
Tsunoda
Koichi
K
Department of Artificial Organs, National Institute of Sensory Organs, 2-5-1 Higashigaoka, Meguroku, Tokyo 152-8902, Japan. tsunodakoichi@kankakuki.go.jp
Kondou
Kenji
K
Kaga
Kimitaka
K
Niimi
Seiji
S
Baer
Thomas
T
Nishiyama
Koichiro
K
Hirose
Hajime
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D005205:Fascia / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D005931:Glottis / Q000503:physiopathology; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery; D007828:Laryngoscopy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010699:Phonation; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function; D049489:Stroboscopy; D013997:Time Factors; D014182:Transplantation, Autologous; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014832:Voice Disorders / Q000601:surgery