Autogenous fat injection for glottic insufficiency: analysis of 101 cases and correlation with patients' self-assessment.
CONCLUSIONS
Our data confirm that fat injection (FI) is a safe, useful, thorough and experience-dependent procedure. It should be considered as a potential treatment protocol for patients with vocal fold atrophy (VFA) and sulcus vergeture (SVER). To increase the chances of excellent phonatory results for sulcus vocalis (SV) patients, our recommended surgical option is FI with fascia transplantation.


OBJECTIVE
To investigate prognostic factors in patients with glottic insufficiency following FI.


METHODS
The study sample comprised 101 patients treated for VFA (n=31), SVER (n=41) and SV (n=29). A retrospective analysis was performed by means of patient self-assessments, employing multiple logistic regressions for the four independent factors of age, gender, diagnosis and time-frame of surgery.


RESULTS
The mean follow-up time was 16.8 months (range 5-38 months). Immediate complications included hematoma of the donor site in two patients and fat extrusion at the injection site in three. The results of treatment were "excellent" in 48.4% (15/31) of VFA cases, 43.9% (18/41) of SVER cases and 20.7% (6/29) of SV cases, with 19.4% (6/31), 24.4% (10/41) and 55.2% (16/29), respectively reporting improvement and 32.3% (10/31), 31.7% (13/41) and 24.1% (7/29), respectively reporting no improvement. Disease type was determined to have a significant bearing (p=0.025) on treatment effectiveness and patients operated on most recently were shown to have a 4.3-times greater chance of achieving successful results (p<0.01). Multiple logistic regression analysis indicated that VFA and SVER sufferers (as compared to those with SV) and men (as opposed to women) were more likely to achieve an "excellent" result: 3.4, 3.3 and 3.6 times, respectively.
Hsiung
Ming-Wang
MW
Department of Otolaryngology, Tri-Service General Hospital, Taipei, Taiwan. mingwan.hsiung@msa.hinet.net
Pai
Lu
L
D000328:Adult; D000368:Aged; D001284:Atrophy / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007267:Injections; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D050507:Subcutaneous Fat, Abdominal / Q000637:transplantation*; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology* / Q000601:surgery