Autologous fat injection for unilateral vocal fold paralysis

Area of Science:

• Otolaryngology
• Regenerative Medicine

Background:

• Unilateral vocal fold paralysis significantly impairs voice quality.
• Medialization techniques aim to restore vocal fold function and improve voice.
• Autologous fat injection is a minimally invasive option for vocal fold medialization.

Purpose of the Study:

• To evaluate the efficacy and duration of autologous fat injection for vocal fold medialization in patients with unilateral vocal fold paralysis.
• To assess the safety and feasibility of this procedure.

Main Methods:

• 21 patients with unilateral vocal fold paralysis underwent autologous abdominal fat injection into the thyroarytenoid muscle.
• Patients were followed with serial videolaryngoscopy and voice evaluations.
• Magnetic resonance imaging (MRI) assessed fat volume and persistence in the larynx.

Main Results:

• At 2 months, 10 patients had excellent voice, 6 had improved but breathy voice, and 4 had markedly breathy voice.
• Voice quality showed variability over time, with some patients experiencing decreased results after 3-4 months.
• MRI indicated fat volume persistence but a decrease in signal over time, suggesting absorption and potential muscle atrophy.

Conclusions:

• Autologous fat injection provides temporary vocal fold medialization with variable duration, lasting at least 2-3 months.
• The procedure is safe and easy to perform, making it suitable for patients expecting return of vocal fold function.
• Further research is needed to optimize fat graft survival and long-term efficacy.