title: Feasibility and potential value of lipofilling in post-treatment oropharyngeal dysfunction.
abstract: Head and neck cancer (HNC) patients may develop oropharyngeal dysfunction as result of volume loss or muscle atrophy of the tongue or pharyngeal musculature following treatment with surgery and/or chemoradiotherapy. If intensive swallowing therapy offers no further improvement, and the functional problems persist, transplantation of autologous adipose tissue (lipofilling) might restore functional outcomes by compensating the existing tissue defects or tissue loss.
  
  
  
  Case series.
  
  
  
  In this prospective pilot feasibility study, the application of lipofilling was studied in seven HNC patients with chronic dysphagia. The procedure was carried out under general anesthesia in several sessions using the Coleman technique. Swallowing outcomes were evaluated with standard videofluoroscopy (VFS) for obtaining objective Penetration Aspiration Scale (PAS) and residue scores. Subjective Functional Oral Intake Scale scores and Swallowing Quality of Life Questionnaire were also completed. Magnetic resonance imaging was used to evaluate the post-treatment injected fat.
  
  
  
  Five patients completed the intended three lipofilling sessions, whereas two completed two injections. One patient dropped out of the study after two injections because of progressive dysphagia requiring total laryngectomy. Four of the six remaining patients showed improved PAS scores on post-treatment VFS assessments, with two patients no longer showing aspiration for a specific consistency. Two patients were no longer feeding tube dependent. Patient-reported swallowing and oral intake improved in four out of six patients.
  
  
  
  Based on the results, the lipofilling technique seems safe and, in selected cases, of potential value for improving swallowing function in this small therapy-refractory HNC patient cohort.
  
  
  
  4 Laryngoscope, 126:2672-2678, 2016.
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Sophie A C
authors.initials: SA
authors.lastname: Kraaijenga
authors.affiliation: Department of Plastic Reconstructive and Hand Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Oren
authors.initials: O
authors.lastname: Lapid
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Lisette
authors.initials: L
authors.lastname: van der Molen
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
authors.forename: Frans J M
authors.initials: FJ
authors.lastname: Hilgers
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.|Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Ludwig E
authors.initials: LE
authors.lastname: Smeele
authors.affiliation: Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands.|Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, the Netherlands.|Institute of Phonetic Sciences/ACLC, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects
keywords: Head and neck neoplasms; autologous fat injection; deglutition; deglutition disorders; fat transfer; lipofilling