Vocal fold augmentation with autologous fat following transoral laryngeal surgery

Transoral laryngeal surgery (TOLS) may lead to glottic insufficiency and scarring which often causes pronounced hoarseness and sometimes swallowing impairment. Injection laryngoplasty with autologous fat is an established method to restore glottic competence and thus improve voice and swallowing function. We hereby aim to demonstrate how laryngeal fat injection can be applied following TOLS.

Autologous fat is harvested via liposuction and then centrifuged for three minutes at 3000 rpm (rpm) to separate fat cells from liquid fat and debris. Fat cells are then transferred to 1 ml Luer-Lock syringes and injected into the altered larynx via a 20 Gauge (0,9 mm) diameter injection needle under microscopic or endoscopic view. The primary objective hereby is approximation of remaining tissue on the glottic plain. The secondary objective is injection into areas of scarified tissue due to the beneficial effect of Adipose-Derived Mesenchymal Stem Cells and possible restoration of physiological laryngeal tissue properties. Injection laryngoplasty with autologous fat tissue may improve laryngeal function after partial laryngeal resection by laser surgery. Special attention needs to be paid to the specific individual postoperative anatomy of the patient's larynx as this may differ profoundly from patient to patient.