Autologous Fat Injection into the Vocal Folds: Technical Considerations and Long-Term Follow-up

Authors

  • Gary Y. Shaw MD,

    Corresponding author
    1. Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A.
    • Gary Y. Shaw, MD, Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160, U.S.A.
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  • Mark A. Szewczyk MD,

    1. Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A.
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  • Jeff Searle CCC-SLP,

    1. Department of Speech and Hearing, University of Kansas Medical Center, Kansas City, Kansas, U.S.A.
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  • Janet Woodroof MD

    1. Department of Pathology, University of Kansas Medical Center, Kansas City, Kansas, U.S.A.
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  • Presented at the Meeting of the Middle Section of the American Laryngological, Rhinological and Otological Society, Inc., Dearborn, MI, January 20, 1996.

Abstract

Numerous materials have been used over the years for vocal fold augmentation. Early use of bioreactive compounds, such as paraffin, gave way to relatively inert substances, such as Teflon. More recently biocompatible materials, such as collagen and autologous fat, have gained wider acceptance. Autologous fat, in particular, is an easily obtainable source for potential rehabilitation of scarred, paralytic, and atrophic vocal folds. However, long-term systematic follow-up has been lacking. Since 1991 we at the University of Kansas Center for Voice and Swallowing Disorders have employed autologous fat for vocal fold augmentation, primarily for either paralysis or repair of a volume-deficient vocal fold segment. Twenty-two patients have completed ≥1 year of follow-up studies, including graded videolaryngostroboscopy, electroglottography, computerized acoustic analysis, and blinded perceptual analysis by two speech-language pathologists. Statistically significant improvement was demonstrated in many parameters tested, frequently improving with time. Although the volume-deficient group had more “normal” values, the paralysis group had greater improvement in many variables using fat injection. We conclude that while autologous fat injections of the vocal fold may have long-term benefits, certain technical considerations and criteria of selection of patients are critical for success.

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