title: Augmentation after microsurgical removal of vocal fold nodules.
abstract: OBJECTIVE
  Innovative otolaryngologists, speech language pathologists, and voice scientists have continued to move forward in understanding the etiology and treatment of vocal nodules. The present article reviews the publications with respect to the advances in this area.
  
  
  RESULTS
  There is support for the notion that there is a positive relationship between vocal nodules and the presence of a posterior glottic chink (PGC). Generalized tension in all the laryngeal muscle is often associated with the PGC due to persistent posterior cricoarytenoid muscle pull during phonation. This phenomenon leads to secondary mucosal change with formation of vocal nodules. Fat augmentation after microsurgical removal of vocal nodules can reduce both the occurrence of a PGC and posterior cricoarytenoid muscle activity and subsequently decrease vocal nodule recurrence. Therefore, the treatment efficiency and protocol are direct and fast. Finally, long-term outcomes studies have demonstrated improvements in vocal disability with both objective and subjective evaluation.
  
  
  CONCLUSIONS
  Fat augmentation is an effective autogenous implant which may be considered in the management of patients after microsurgical removal of nodules.
authors.affiliation: Department of Otolaryngology, Tri-Service General Hospital & National Defense Medical Center, Taipei, Taiwan, ROC. mingwan.hsiung@msa.hinet.net
authors.forename: Ming-Wang
authors.initials: MW
authors.lastname: Hsiung
authors.forename: Jin-Chin
authors.initials: JC
authors.lastname: Lee
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D008866:Microsurgery; D014182:Transplantation, Autologous; D014827:Vocal Cords