Long-term Survival of Autologous Fat Grafts into the Vocal Folds

Abstract

Objectives:

Determine whether long-term survival of fat implanted into the vocal folds is possible.

Methods:

Nine patients of those treated between 1992 and 2005 by means of bilateral fat injection into the vocal folds responded the call to assess long term results. Initial diagnosis was unilateral vocal fold palsy (6) and superficial sulcus (3). The graft was obtained by means of dissection of fat from the abdominal wall, and injected with an 18 G needle into the body of the vocal folds until 50% over correction was achieved. In palsy cases a higher fat volume was required on the paralyzed side. All patients underwent laryngostroboscopic examination preoperatively and postoperatively, along with postoperative magnetic resonance imaging (MRI) of the larynx, 4 to 14 years after surgery. As far as MRI is concerned, spine echo and fat-suppressed sequences in axial coronal and sagittal planes were obtained, looking for high intensity areas in T1-weighted images at the level of the vocal folds.

Results:

Laryngostroboscopy demonstrated permanent augmentation of the vocal folds with glottic closure improvement. MRI images in all cases showed the presence of enough fat in the body of the vocal folds, acting as support for good size and shape of the structure.

Conclusions:

Autologous fat cells injected into the vocal folds can survive years after surgery, acting as a permanent filler. Those conditions are in favor of fat grafts to be used as an inexpensive, easy to use, and long-lasting implant for selected cases of glottic incompetence.