Summary
Objective
To evaluate the improvements in vocal function and glottal form before and after autologous
fat injection laryngoplasty in relation to the injected total fat volume in patients
with unilateral vocal fold paralysis.
Design
Clinical study.
Methods
Seventy-three patients with unilateral vocal fold paralysis received fat injection
laryngoplasty and were divided into low-volume injection (<3 mL; average, 2.0 mL)
and high-volume injection (≥3 mL; average, 4.3 mL) groups. Voice function before and
after fat injection laryngoplasty were examined by aerodynamics evaluations, pitch
and intensity measurements, and acoustic analyses. The glottal form before and after
fat injection laryngoplasty was determined by measuring the ratio of vocal fold bowing
(bowing ratio) and the ratio of lengths between bilateral vocal process (width ratio)
at an easy phonation under laryngeal endoscopic examination. The postoperative parameters
were evaluated for a median period of four years after fat injection laryngoplasty.
The differences between pre- and postoperative parameters were examined separately
for each group by the paired t-test. For each variable, a comparison of the effects of surgery was conducted using
an analysis of covariance model with the change between the pre- and postoperative
values as a dependent variable and the preoperative value as a covariate.
Results
In both groups, all parameters of voice function and glottal form after surgery significantly
improved in comparison to those before surgery. Maximum phonation time, amplitude
perturbation quotient, and normalized noise energy for 0 to 4 kHz in the high-volume
group improved more significantly in comparison to those in the low-volume group.
Conclusions
As a rough guide for males, injection of more than 3 mL of autologous fat to the vocal
muscle layer is recommended for reliable improvement of voice function in patients
with unilateral vocal fold paralysis.
Key Words
Abbreviations:
AA (Arytenoid adduction), ANCOVA (Analysis of covariance), APQ (Amplitude perturbation quotient), BR (Bowing ratio), FIL (Fat injection laryngoplasty), HV (High volume), LV (Low volume), MFR (Mean flow rate), MPT (Maximum phonation time), NNEa (Normalized noise energy for 0 to 4 kHz), PPQ (Pitch perturbation quotient), RLNP (Recurrent laryngeal nerve paralysis), SPL (Sound pressure level), TP (Thyroplasty type I), UVFP (Unilateral vocal fold paralysis), WR (Width ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 17, 2022
Accepted:
August 17,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
