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Treatment of velopharyngeal insufficiency by autologous fat injection

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Abstract

Velopharyngeal insufficiency (VPI) is a structural or functional trouble, which causes hypernasal speech. Velopharyngeal flaps, speech therapy and augmentation pharyngoplasty, using different implants, have all been used to address this trouble. We hereby present our results following rhinopharyngeal autologous fat injection in 18 patients with mild velopharyngeal insufficiency (12 soft palate clefts, 4 functional VPI, 2 myopathy). 28 injections were carried out between 2004 and 2007. The degree of hypernasal speech was evaluated pre- and postoperatively by a speech therapist and an ENT specialist and quantified by an acoustic nasometry (Kay Elemetrics™). All patients were exhaustively treated with preoperative speech therapy (average, 8 years). The mean value of the nasalance score was 37% preoperatively and 23% postoperatively (p = 0.015). The hypernasality was reduced postoperatively in all patients (1–3 degrees of the Borel-Maisonny score). There were no major complications, two minor complications (one hematoma, one cervical pain). The autologous fat injection is a simple, safe, minimally invasive procedure. It proves to be efficient in cases of mild velopharyngeal insufficiency or after a suboptimal velopharyngoplasty.

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Authors and Affiliations

  1. Department of Otolaryngology, University Hospital Centre of the Canton of Vaud (CHUV), 1011, Lausanne, Switzerland

    Igor Leuchter, Valérie Schweizer & Philippe Pasche

  2. Department of Paediatric Surgery, University Hospital Centre of the Canton of Vaud (CHUV), 1011, Lausanne, Switzerland

    Judith Hohlfeld

  3. Service ORL et Chirurgie Cervico-Faciale, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland

    Igor Leuchter

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  1. Igor Leuchter
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  2. Valérie Schweizer
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  4. Philippe Pasche
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Correspondence to Igor Leuchter.

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Leuchter, I., Schweizer, V., Hohlfeld, J. et al. Treatment of velopharyngeal insufficiency by autologous fat injection. Eur Arch Otorhinolaryngol 267, 977–983 (2010). https://doi.org/10.1007/s00405-009-1157-7

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  • DOI: https://doi.org/10.1007/s00405-009-1157-7

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