title: [Vocal fold augmentation by injection of autologous fascia and fat].
abstract: OBJECTIVE
  To evaluate the effect of combination of autologous fascia and fat injection into vocal fold for the treatment of patients with unilateral vocal fold paralysis and to observe the long-term effectiveness of this procedure.
  
  
  METHODS
  A total of 26 unilateral vocal fold paralysis patients underwent vocal fold injection under general anesthesia, meanwhile, the mucosa of the injected point was sutured through laryngoscope under direct vision. There were 6 patients underwent autologous fat injection into vocal fold (group A), and 20 patients underwent autologous anterior rectus sheath fascia and fat injection (group B). Therapeutic efficacy were evaluated by videostroboscopy, voice-related parameters analysis and voice evaluation before and after treatment. Clinical analysis of this procedure was retrospectively performed in this serial of patients.
  
  
  RESULTS
  All patients were followed up for 24 months. On the third day after operation, there was an acute inflammatory reaction induced by the graft. This reaction disappeared three months later. In all 20 cases, videolaryngostroboscopy showed significant improvement of the glottic closure, the improvement in acoustical parameters was statistically significant (P < 0.01). Perceptual evaluation of GRBAS scale showed significant improvement of phonatory function on G, B, A scale. The results remained stable 6 - 24 months after operation and were not changed by the length of follow-up. And in the 6 cases, videolaryngostroboscopy showed significant improvement of the glottic closure at 3 months compared with preoperative observation, a little spindle-shaped disclosure. The improvement in acoustical parameters was significant statistically at 3, 6 and 24 months (P < 0.05 or < 0.01), the voice quality decreased significantly at 6 and 24 months compared with 3 months (P < 0.05 or < 0.01). The significant differences were not observed between 6 and 24 months (P > 0.05). No complications were observed in all patients perioperatively or during the follow-up period. Voice-related parameters jitter, normalized noise energy and maximum phonation time showed significant differences between Group A and Group B on 24 months (P < 0.05 or < 0.01).
  
  
  CONCLUSIONS
  The combination of autologous fascia and fat vocal fold injection is an effective procedure for the treatment of unilateral vocal fold paralysis, and the stable results can be achieved during the follow-up period for 24 months.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China. whbotologic797@163.com
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Zheng-hua
authors.initials: ZH
authors.lastname: Lü
authors.forename: Ji-dong
authors.initials: JD
authors.lastname: Zou
authors.forename: Hong-yuan
authors.initials: HY
authors.lastname: Cao
authors.forename: Hai-bo
authors.initials: HB
authors.lastname: Wang
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014827:Vocal Cords / Q000637:transplantation; D014833:Voice Quality; D055815:Young Adult