TY - JOUR
T1 - Structural Fat Grafting to Improve Outcomes of Vocal Folds’ Fat Augmentation
T2 - Long-term Results
AU - Cantarella, Giovanna
AU - Mazzola, Riccardo F.
AU - Gaffuri, Michele
AU - Iofrida, Elisabetta
AU - Biondetti, Pietro
AU - Forzenigo, Laura V.
AU - Pignataro, Lorenzo
AU - Torretta, Sara
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: Evaluating the long-term outcomes of vocal fold structural fat grafting. Study Design: Case series with chart review. Setting: University hospital. Subjects and Methods: Seventy-nine dysphonic patients (16-82 years; 55 with unilateral laryngeal paralysis and 24 with vocal fold scarring) underwent vocal fold fat injection. Fat was harvested by low-pressure liposuction and then processed by centrifugation. Refined fat aliquots were placed in the vocal fold and paraglottic space in multiple tunnels to enhance graft neovascularization. All patients were followed for 12 months, 15 for 3 years, and 5 for 10 years with videolaryngostroboscopy, maximal phonation time (MPT) measurement, Voice Handicap Index (VHI) questionnaire, and GRBAS (grade, roughness, breathiness, asthenia, strain) perceptual evaluation. Laryngeal computed tomography (CT) and/or magnetic resonance imaging (MRI) studies were performed in 16 patients 3 to 28 months postoperatively; MRI was repeated in 5 cases 12 to 18 months after the first radiological study. Results: The voice quality of all patients improved after surgery, and long-term stability was confirmed by MPT, GRBAS, and VHI (P ranging between.004 and <.001). The results achieved 1 year postoperatively remained stable at 3 and 10 years. Videolaryn-gostroboscopy showed improved glottic closure in all patients despite a limited amount of fat resorption. CT and MRI demonstrated survival of the fat grafts in all of the 16 examined cases. Serial MRI scans showed no change in graft size over time. Conclusions: The reported clinical and radiological data demonstrate that fat is an effective filler for permanent vocal fold augmentation if the refined micro-aliquots are placed in multiple tunnels.
AB - Objective: Evaluating the long-term outcomes of vocal fold structural fat grafting. Study Design: Case series with chart review. Setting: University hospital. Subjects and Methods: Seventy-nine dysphonic patients (16-82 years; 55 with unilateral laryngeal paralysis and 24 with vocal fold scarring) underwent vocal fold fat injection. Fat was harvested by low-pressure liposuction and then processed by centrifugation. Refined fat aliquots were placed in the vocal fold and paraglottic space in multiple tunnels to enhance graft neovascularization. All patients were followed for 12 months, 15 for 3 years, and 5 for 10 years with videolaryngostroboscopy, maximal phonation time (MPT) measurement, Voice Handicap Index (VHI) questionnaire, and GRBAS (grade, roughness, breathiness, asthenia, strain) perceptual evaluation. Laryngeal computed tomography (CT) and/or magnetic resonance imaging (MRI) studies were performed in 16 patients 3 to 28 months postoperatively; MRI was repeated in 5 cases 12 to 18 months after the first radiological study. Results: The voice quality of all patients improved after surgery, and long-term stability was confirmed by MPT, GRBAS, and VHI (P ranging between.004 and <.001). The results achieved 1 year postoperatively remained stable at 3 and 10 years. Videolaryn-gostroboscopy showed improved glottic closure in all patients despite a limited amount of fat resorption. CT and MRI demonstrated survival of the fat grafts in all of the 16 examined cases. Serial MRI scans showed no change in graft size over time. Conclusions: The reported clinical and radiological data demonstrate that fat is an effective filler for permanent vocal fold augmentation if the refined micro-aliquots are placed in multiple tunnels.
KW - dysphonia
KW - glottic incompetence
KW - structural fat grafting
KW - vocal fold paralysis
KW - vocal fold scarring
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U2 - 10.1177/0194599817739256
DO - 10.1177/0194599817739256
M3 - Article
AN - SCOPUS:85040125896
VL - 158
SP - 135
EP - 143
JO - Otolaryngology - Head and Neck Surgery
JF - Otolaryngology - Head and Neck Surgery
SN - 0194-5998
IS - 1
ER -