Abstract
Unilateral vocal fold paralysis resulting in glottic incompetence can cause impairment of laryngeal functions, including airway protection and phonation. The objective of this study is to present an easy new technique for harvesting and injection of abdominal fat into the vocal fold for patients with unilateral vocal fold paralysis. This is a retrospective study of patients carried out on 16 patients suffering from unilateral vocal fold paralysis resulting from different etiologies. All patients were subjected to the protocol of voice assessment pre- and postoperatively. All patients were subjected to fat injection of the paralyzed vocal fold. There was a statistically significant difference between the pre- and postoperative grade of voice parameters. Vocal fold injection using fat medializes a paralyzed vocal fold by increasing vocal fold volume. Fat injections are safe and easily mastered; and in the absence of the standard settings for fat harvesting and injection, it could be performed with minimal equipment that are readily available in any operating room.
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References
Mesallam TA, Khalil YA, Malki KH, Farahat M (2011) Medialization thyroplasty using autologous nasal septal cartilage for treating unilateral vocal fold paralysis. Clin Exp Otorhinolaryngol 4(3):142–148
Cohen MS, Mehta DK, Maguire RC, Simons JP (2011) Injection medialization laryngoplasty in children. Arch Otolaryngol Head Neck Surg 137(3):264–268
Fang TJ, Li HY, Gliklich RE, Chen YH, Wang PC, Chuang HF (2010) Outcomes of fat injection laryngoplasty in unilateral vocal cord paralysis. Arch Otolaryngol Head Neck Surg 136(5):457–462
Chan RW, Titze IR (1998) Viscosities of implantable biomaterials in vocal fold augmentation surgery. Laryngoscope 108(5):725–731
Perie S, Roubeau B, Liesenfelt I, Chaigneau-Debono G, Bruel M, St Guily JL (2002) Role of medialization in the improvement of breath control in unilateral vocal fold paralysis. Ann Otol Rhinol Laryngol 111(11):1026–1033
Spector BC, Netterville JL, Billante C, Clary J, Reinisch L, Smith TL (2001) Quality-of-life assessment in patients with unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 125(3):176–182
Schneider B, Bigenzahn W, End A, Denk DM, Klepetko W (2003) External vocal fold medialization in patients with recurrent nerve paralysis following cardiothoracic surgery. Eur J Cardiothorac Surg 23(4):477–483
Fang TJ, Li HY, Gliklich RE, Chen YH, Wang PC, Chuang HF (2008) Quality of life measures and predictors for adults with unilateral vocal cord paralysis. Laryngoscope 118(10):1837–1841
Fang TJ, Li HY, Gliklich RE, Chen YH, Wang PC (2007) Assessment of Chinese-version voice outcome survey in patients with unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 136(5):752–756
Stuut M, Tjon Pian Gi RE, Dikkers FG (2014) Change of Voice Handicap Index after treatment of benign laryngeal disorders. Eur Arch Otorhinolaryngol 271(5):1157–1162
Fang TJ, Lee LA, Wang CJ, Li HY, Chiang HC (2009) Intracordal fat assessment by 3-dimensional imaging after autologous fat injection in patients with thyroidectomy-induced unilateral vocal cord paralysis. Surgery 146(1):82–87
Bouwers F, Dikkers FG (2009) A retrospective study concerning the psychosocial impact of voice disorders: Voice Handicap Index change in patients with benign voice disorders after treatment (measured with the Dutch version of the VHI). J Voice 23(2):218–224
Rosen CA, Murry T, Zinn A, Zullo T, Sonbolian M (2000) Voice handicap index change following treatment of voice disorders. J Voice 14(4):619–623
Umeno H, Chitose S, Sato K, Ueda Y, Nakashima T (2012) Long-term postoperative vocal function after thyroplasty type I and fat injection laryngoplasty. Ann Otol Rhinol Laryngol 121(3):185–191
Zhang HY, Xu W, Lu ZH, Zou JD, Cao HY, Wang HB (2011) Vocal fold augmentation by injection of autologous fascia and fat. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 46(4):269–274
Shvero J (2011) Fat injection as treatment for vocal cord palsy: our experience in 21 patients. Harefuah 150(2):87–90 (208)
Umeno H, Chitose S, Sato K, Nakashima T (2009) Comparative study of framework surgery and fat injection laryngoplasty. J Laryngol Otol Suppl (31):35–41
Woo SH, Son YI, Lee SH, Park JJ, Kim JP (2013) Comparative analysis on the efficiency of the injection laryngoplasty technique using calcium hydroxyapatite (CaHA): the thyrohyoid approach versus the cricothyroid approach. J Voice 27(2):236–241
Rees CJ, Mouadeb DA, Belafsky PC (2008) Thyrohyoid vocal fold augmentation with calcium hydroxyapatite. Otolaryngol Head Neck Surg 138(6):743–746
Zeitler DM, Amin MR (2007) The thyrohyoid approach to in-office injection augmentation of the vocal fold. Curr Opin Otolaryngol Head Neck Surg 15(6):412–416
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Author Hisham E.M. Elbadan, MD declares that he has no conflict of interest. Author Wael K.A. Hussein, MD declares that he has no conflict of interest. Author Riham M. Elmaghraby, MD declares that she has no conflict of interest.
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.
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Informed consent was obtained from all individual participants included in the study.
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Elbadan, H.E.M., Hussein, W.K.A. & Elmaghraby, R.M. Transcervical fat injection laryngoplasty for unilateral vocal fold paralysis: an easy way to do the job. Eur Arch Otorhinolaryngol 274, 4161–4167 (2017). https://doi.org/10.1007/s00405-017-4758-6
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DOI: https://doi.org/10.1007/s00405-017-4758-6