Laryngeal complications after lipoinjection for vocal fold augmentation.
OBJECTIVE
Vocal fold augmentation with autologous fat has been widely used for the last 15 years with varying success. Autologous fat is biocompatible, readily available, and easily harvested, making it a commonly used material for vocal fold augmentation. Although felt to be a relatively safe procedure, few studies have looked at the complication rate of lipoinjection for vocal fold augmentation.


METHODS
Retrospective review.


METHODS
Ninety-eight vocal fold injections were performed at one institution from 1997 to 2008. The charts were reviewed retrospectively, and age, diagnosis, side of procedure, concurrent procedures, length of follow-up, and complications during or subsequent to the injection were recorded in a database. Patients were excluded if data was inadequate to make a determination regarding complication during or after lipoinjection.


RESULTS
Eighty-eight patients met the criteria for review with an average age of 57.4 years. The most common indications for injection were vocal fold paresis, vocal fold scarring, and presbylaryngeus. Mean follow-up was 20.2 months with a range of 0 months to 126 months. Overall, four laryngeal complications occurred (4.5%), including three over-injections (3.4%) leading to poor voice quality and one granuloma formation (1.1%). The over-injections were managed using cordotomy with fat removal, resulting in vocal improvement in all cases.


CONCLUSIONS
Although lipoinjection vocal fold augmentation is a safe procedure, over-injection of autologous fat is a risk. Lipoinjection for vocal fold augmentation can lead to over-injection with dysphonia in a small number of patients. The complications can be managed with lateral cordotomy and fat removal.
Sanderson
J Drew
JD
Department of Otolaryngology, University of Texas Health Science Center at San Antonio, 78229, USA.
Simpson
C Blake
CB
D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007818:Laryngeal Diseases / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D016378:Tissue Transplantation / Q000009:adverse effects* / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014741:Video Recording; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000601:surgery; D014827:Vocal Cords / Q000473:pathology / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology / Q000601:surgery*; D014833:Voice Quality; D055815:Young Adult