Structural Fat Grafting to Improve Outcomes of Vocal Folds’ Fat Augmentation: Long-term Results

Giovanna Cantarella, Riccardo F. Mazzola, Michele Gaffuri, Elisabetta Iofrida, Pietro Biondetti, Laura V. Forzenigo, Lorenzo Pignataro, Sara Torretta

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)135-143
Number of pages9
JournalOtolaryngology - Head and Neck Surgery (United States)
Issue number1
Publication statusPublished - Jan 1 2018


  • dysphonia
  • glottic incompetence
  • structural fat grafting
  • vocal fold paralysis
  • vocal fold scarring

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


Dive into the research topics of 'Structural Fat Grafting to Improve Outcomes of Vocal Folds’ Fat Augmentation: Long-term Results'. Together they form a unique fingerprint.

Cite this