Autologous Fat Injection through the Cricothyroid Membrane Improves Voice in Patients with Unilateral Vocal Fold...

Traditional fat injection techniques still have some limitations, such as inevitable fat resorption, operative fat overflow, and the lack of standardized procedural techniques, which result in worse voice improvement. This study aims to present our experience with a modified autologous fat injection technique through the cricothyroid membrane, designed to improve glottic closure and voice function in patients with unilateral vocal fold paralysis (UVFP).

Sixteen consecutive cases of UVFP, 36.9 years (range, 18-71 years), underwent autologous fat injection through the cricothyroid membrane. Abdominal fat was harvested from the abdomen, mixed with short-acting insulin and dexamethasone, and injected into the paralyzed vocal fold under suspension laryngoscopy. Voice Handicap Index (VHI), perceptual voice assessments (Grade, Roughness, Breathiness, Asthenia, Strain [GRBAS]), Objective acoustic parameters, and endoscopic assessment of glottal closure were measured preoperatively and at 1 and 6 months postoperatively.

The mean follow-up for this group of patients was 183 days. Over the follow-up period, all 16 patients demonstrated significant improvement in vocal fold closure, which resulted in better voice compared to that of preoperation, such as the degree of the VHI-30 scores (P < 0.001), the maximum phonation time (P < 0.001), the maximum loudest phonation time (P < 0.05), harmonics-to-noise ratio (P < 0.001), jitter (P < 0.05), shimmer (P < 0.001), glottic gap (P < 0.001), and the GRBAS scale (P < 0.01).

Autologous fat injection mixed with short-acting insulin and dexamethasone, through the cricothyroid membrane, was associated with improvements in glottic closure and vocal function in patients with UVFP.

Level 4.