title: Augmentation Autologous Adipose Injections in the Larynx.
abstract: OBJECTIVE
  Autologous adipose injection (AAI) is a recognized method for vocal fold augmentation. The study's purpose is to explore short- and long-term outcomes of AAI.
  
  
  METHODS
  Retrospective chart review of 43 patients undergoing AAI was performed; patient perception of outcome, Voice Handicap Index (VHI), maximum phonatory time (MPT), and disposition were evaluated.
  
  
  RESULTS
  Over 5 years, 43 AAI patients had documented postoperative follow-up (25 paralysis, 8 paresis, 9 bowing/presbylarynges, and 5 scar/sulci). Mean follow-up was 32 weeks. There was gradual patient loss to follow-up. Thirty-nine of 40 (98%) had patient-reported improvement at 6 weeks, 28 of 34 (82%) had improvement at 2 to 6 months, with 10 of 12 (83%) sustaining their improvement for >1 year. Significant improvement in mean VHI was observed at 4 to 6 weeks (mean reduction, 26; P < .0001) and 2 to 6 months (mean reduction, 23; P < .0001). Improvement in mean MPT was observed at 4 to 6 weeks (mean increase, 8 s; P < .0001), 2 to 6 months (6 s; P = .007), and >1 year (4 s; P = .03). Eight patients went on to medialization laryngoplasty.
  
  
  CONCLUSIONS
  AAI successfully augments vocal folds in short-term outcomes with some gradual decrease in effectiveness. Although patient attrition limited conclusions, objective long-term benefit may occur in >50% of patients.
authors.affiliation: Cleveland Clinic Department of Otolaryngology, Head and Neck Surgery, Cleveland, Ohio, USA benninm@ccf.org.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Benninger
authors.affiliation: Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Hanick
authors.affiliation: Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Nowacki
mesh_terms: D050153:Abdominal Fat / Q000637:transplantation*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D058753:Laryngoplasty; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality; D055815:Young Adult
keywords: autologous adipose injection; laryngoplasty