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Long‐Term Follow‐up of Fat Injection Laryngoplasty for Unilateral Vocal Cord Paralysis
Author(s) -
McCulloch Timothy M.,
Andrews Brian T.,
Hoffman Henry T.,
Graham Scott M.,
Karnell Michael P.,
Minnick Corey
Publication year - 2002
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200207000-00017
Subject(s) - medicine , laryngoplasty , vocal cord paralysis , surgery , demographics , cord , paralysis , retrospective cohort study , anesthesia , larynx , demography , sociology
Objective The objective of the study was to evaluate the results of autologous fat injection laryngoplasty in the long‐term management of unilateral vocal cord paralysis. Study Design A retrospective chart review and clinical voice re‐evaluation of patients treated for unilateral vocal cord paralysis with autologous fat injection at the University of Iowa Hospitals and Clinics (Iowa City, IA) between May 1992 and September 1999. Methods The data analyzed included patient demographics, early and long‐term vocal outcomes, additional surgical treatments, and patient survival. Results Fifty patients were treated with fat injection laryngoplasty, which included 44 treated for unilateral vocal cord paralysis. Thirty‐one of the patients had fat injection as their primary procedure for permanent voice restoration. Eight patients treated had preoperative and postoperative voice data available. Using the GRBAS subjective voice assessment scale (0, normal; 3, severely abnormal), mean grade improved from 2.1 to 1.3 and breathiness improved from 1.4 to 0.5, at a mean period of 52 days. Thirteen of the 31 patients (41%) required additional procedures to achieve acceptable vocal outcomes. The median time to failure for these patients was 163 days. The initial treatment failure rate at 2 years was 30%, and the rate reached 45% by 4 years. Conclusion Although fat injection laryngoplasty reliably improves the voice over the short term, the long‐term voice outcome is unpredictable. Additional surgeries to deal with subsequent vocal deterioration are common. The role of autologous fat injection laryngoplasty in the modern era is limited.