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European Archives of Oto-Rhino-Laryngology

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Open Access 18-12-2023 | Autologous Fat | Laryngology

3D-exoscopic microlaryngoscopy in phonosurgery for glottic insufficiency

Authors: Hans N. C. Eckel, Antonia Nolte, Martin S. Otte, Sami Shabli, Ruth Lang-Roth, Jens P. Klußmann, Kevin K. Hansen

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2024

Abstract

Purpose

We hypothesized that using a 3D-exoscope (3Dex) in microlaryngoscopic phonosurgery is non-inferior to using a standard operating microscope (OM). To compare the above, we utilized a 3Dex and an OM for microlaryngoscopic vocal fold augmentation with autologous fat in patients with glottic insufficiency and compared the procedure itself and the long-term impact of vocal fold augmentation on subjective and objective voice parameters in both groups.

Methods

36 patients with glottic insufficiency received microlaryngoscopic laryngeal augmentation with autologous fat. A 3Dex was utilized in 24 cases for visualization and compared to twelve cases in which an OM was used. Voice parameters were evaluated over a period of twelve months.

Results

Comparison of operation time and voice parameters between the 3Dex and OM groups did not reveal significant differences. Significant improvement of mean voice quality in all parameters excluding roughness was observed at 3 and 6 months followed then by a slight decrease of voice quality parameters between the 6 and 12 months interval in both groups.

Conclusion

Our findings indicate no difference concerning operation time and outcome between the use of a 3Dex and an OM in phonosurgery. Our results highlight a significant voice improvement after vocal fold augmentation with autologous fat in glottic insufficiency mediated dysphonia. The smaller viewing system, better ergonomics for the primary surgeon and the assistant and a direct view for the entire surgical team make a 3Dex an interesting alternative for visualization in microlaryngoscopic phonosurgery.

Rosow DE, Pan DR (2019) Presbyphonia and Minimal Glottic Insufficiency. Otolaryngol Clin North Am 52(4):617–625. https://doi.org/10.1016/j.otc.2019.03.005CrossRefPubMed

Brown HJ, Zhou D, Husain IA (2020) Management of presbyphonia: A systematic review of the efficacy of surgical intervention. Am J Otolaryngol 41(4):102532. https://doi.org/10.1016/j.amjoto.2020.102532CrossRefPubMed

Fang TJ, Li HY, Gliklich RE, Chen YH, Wang PC, Chuang HF (2008) Quality of life measures and predictors for adults with unilateral vocal cord paralysis. Laryngoscope 118(10):1837–1841. https://doi.org/10.1097/MLG.0b013e31817e7431CrossRefPubMed

Cohen SM, Dupont WD, Courey MS (2006) Quality-of-life impact of non-neoplastic voice disorders: a meta-analysis. Ann Otol Rhinol Laryngol 115(2):128–134. https://doi.org/10.1177/000348940611500209CrossRefPubMed

Kinshuck AJ, Shenoy A, Jones TM (2017) Voice outcomes for early laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg 25(3):211–216. https://doi.org/10.1097/moo.0000000000000363CrossRefPubMed

Angel D, Doyle PC, Fung K (2011) Measuring voice outcomes following treatment for laryngeal cancer. Expert Rev Pharmacoecon Outcomes Res 11(4):415–420. https://doi.org/10.1586/erp.11.37CrossRefPubMed

Amberger P (2019) Parkinson disease : how to improve the voice and the quality of life. Rev Med Suisse 15(656):1288–1290PubMed

Sund LT, Cameron B, Johns MM 3rd, Gao WZ, O’Dell K, Hapner ER (2021) Laryngologists’ Reported Decision-Making in Presbyphonia Treatment. J Voice. https://doi.org/10.1016/j.jvoice.2021.10.008CrossRefPubMed

10.

Umeno H, Chitose S, Sato K, Ueda Y, Nakashima T (2012) Long-term postoperative vocal function after thyroplasty type I and fat injection laryngoplasty. Ann Otol Rhinol Laryngol 121(3):185–191. https://doi.org/10.1177/000348941212100308CrossRefPubMed

11.

Sulica L et al (2010) Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications. Laryngoscope 120(2):319–325. https://doi.org/10.1002/lary.20737CrossRefPubMed

12.

Marie JP, Hansen K, Brami P, Marronnier A, Bon-Mardion N (2020) Nonselective Reinnervation as a Primary or Salvage Treatment of Unilateral Vocal Fold Palsy. Laryngoscope 130(7):1756–1763. https://doi.org/10.1002/lary.28324CrossRefPubMed

13.

DeFatta RA, Chowdhury FR, Sataloff RT (2012) Complications of injection laryngoplasty using calcium hydroxylapatite. J Voice 26(5):614–618. https://doi.org/10.1016/j.jvoice.2011.08.005CrossRefPubMed

14.

Shaw GY, Szewczyk MA, Searle J, Woodroof J (1997) Autologous fat injection into the vocal folds: technical considerations and long-term follow-up. Laryngoscope 107(2):177–186. https://doi.org/10.1097/00005537-199702000-00008CrossRefPubMed

15.

Brandenburg JH, Unger JM, Koschkee D (1996) Vocal cord injection with autogenous fat: a long-term magnetic resonance imaging evaluation. Laryngoscope 106(2 Pt 1):174–180. https://doi.org/10.1097/00005537-199602000-00013CrossRefPubMed

16.

Brandenburg JH, Kirkham W, Koschkee D (1992) Vocal cord augmentation with autogenous fat. Laryngoscope 102(5):495–500. https://doi.org/10.1288/00005537-199205000-00005CrossRefPubMed

17.

Cantarella G et al (2018) Structural Fat Grafting to Improve Outcomes of Vocal Folds’ Fat Augmentation: Long-term Results. Otolaryngol Head Neck Surg 158(1):135–143. https://doi.org/10.1177/0194599817739256CrossRefPubMed

18.

Lahav Y, Malka-Yosef L, Shapira-Galitz Y, Cohen O, Halperin D, Shoffel-Havakuk H (2021) Vocal Fold Fat Augmentation for Atrophy, Scarring, and Unilateral Paralysis: Long-term Functional Outcomes. Otolaryngol Head Neck Surg 164(3):631–638. https://doi.org/10.1177/0194599820947000CrossRefPubMed

19.

Zelenik K, Formanek M, Walderova R, Formankova D, Kominek P (2021) Five-year results of vocal fold augmentation using autologous fat or calcium hydroxylapatite. Eur Arch Otorhinolaryngol 278(4):1139–1144. https://doi.org/10.1007/s00405-020-06479-6CrossRefPubMed

20.

Benninger MS, Hanick AL, Nowacki AS (2016) Augmentation Autologous Adipose Injections in the Larynx. Ann Otol Rhinol Laryngol 125(1):25–30. https://doi.org/10.1177/0003489415595427CrossRefPubMed

21.

Divitiis DEO, D’Avella E, Denaro L, Somma T, Sacco M, D’Avella D (2022) VITOM®-3D: preliminary experience with intradural extramedullary spinal tumors. J Neurosurg Sci 66(4):356–361. https://doi.org/10.23736/s0390-5616.19.04666-6CrossRefPubMed

22.

Frykman PK, Duel BP, Gangi A, Williams JA, Berci G, Freedman AL (2013) Evaluation of a video telescopic operating microscope (VITOM) for pediatric surgery and urology: a preliminary report. J Laparoendosc Adv Surg Tech A 23(7):639–643. https://doi.org/10.1089/lap.2013.0125CrossRefPubMedPubMedCentral

23.

Manton RN, Ahmed F, Ridha H (2022) Preliminary experience using the VITOM-3D system for microvascular anastomosis in DIEP free flap breast reconstruction. J Plast Reconstr Aesthet Surg 75(2):893–939. https://doi.org/10.1016/j.bjps.2021.11.099CrossRefPubMed

24.

Achena A et al (2022) VITOM-3D assisted paramedian forehead flap for nasal reconstruction. Am J Otolaryngol 43(5):103493. https://doi.org/10.1016/j.amjoto.2022.103493CrossRefPubMed

25.

Rusetsky Y, Chuchueva N, Meytel I, Malyavina U, Farikov S (2022) Exoscopic visualisation with VITOM(®) 3D in paediatric cochlear implantation: Preliminary results. Clin Otolaryngol 47(6):741–745. https://doi.org/10.1111/coa.13902CrossRefPubMed

26.

Mincione A, Lepera D, Rizzi L (2021) VITOM 3D System in Parotid Gland Surgery: Our Experience. J Craniofac Surg 32(2):e138–e141. https://doi.org/10.1097/scs.0000000000006875CrossRefPubMed

27.

Crosetti E, Arrigoni G, Caracciolo A, Tascone M, Manca A, Succo G (2021) VITOM-3D-assisted retroauricular neck surgery (RANS-3D): preliminary experience at Candiolo Cancer Institute. Acta Otorhinolaryngol Ital 41(5):419–431. https://doi.org/10.14639/0392-100x-n1293CrossRefPubMedPubMedCentral

28.

S. Ferlito et al., “High Definition Three-Dimensional Exoscope (VITOM 3D) in E.N.T. Surgery: A Systematic Review of Current Experience,” J Clin Med, vol. 11, no. 13, p. 3639, 2022, [Online]. Available: https://www.mdpi.com/2077-0383/11/13/3639

29.

Carobbio ALC et al (2021) Transoral laser microsurgery: feasibility of a new exoscopic HD-3D system coupled with free beam or fiber laser. Lasers Med Sci 36(9):1865–1872. https://doi.org/10.1007/s10103-020-03221-wCrossRefPubMed

30.

Paderno A, Deganello A, Lancini D, Piazza C (2022) Is the exoscope ready to replace the operative microscope in transoral surgery? Curr Opin Otolaryngol Head Neck Surg 30(2):79–86. https://doi.org/10.1097/moo.0000000000000794CrossRefPubMed

31.

Hansen K, Nolte A, Klussmann JP (2021) Vocal cord augmentation with autologous fat in unilateral vocal cord paralysis. Eur Ann Otorhinolaryngol Head Neck Dis 138(Suppl 3):103–104. https://doi.org/10.1016/j.anorl.2021.04.006CrossRefPubMed

32.

Nishio N et al (2016) Autologous fat injection therapy including a high concentration of adipose-derived regenerative cells in a vocal fold paralysis model: animal pilot study. J Laryngol Otol 130(10):914–922. https://doi.org/10.1017/s0022215116008707CrossRefPubMed

33.

R. Prstačić, J. Slipac, T. Živković Ivanović, I. Šimić, E. Babić, and A. Đanić Hadžibegović, “Autologous Fat Augmentation in the Treatment of Unilateral Vocal Fold Paralysis - A 15-year Experience in a Single Institution,” Acta Clin Croat, vol. 59, no. Suppl 1, pp. 32–37, 2020, doi: https://doi.org/10.20471/acc.2020.59.s1.04.

34.

M. W. Hsiung, P. Woo, A. Minasian, and J. Schaefer Mojica, “Fat augmentation for glottic insufficiency,” Laryngoscope, vol. 110, no. 6, pp. 1026–1033, 2000, doi: https://doi.org/10.1097/00005537-200006000-00026

Title: 3D-exoscopic microlaryngoscopy in phonosurgery for glottic insufficiency
Authors: Hans N. C. Eckel
Antonia Nolte
Martin S. Otte
Sami Shabli
Ruth Lang-Roth
Jens P. Klußmann
Kevin K. Hansen
Publication date: 18-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Autologous Fat
Dysphonia
Dysphonia
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2024
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08345-7

EASD 2024

Springer Medicine

3D-exoscopic microlaryngoscopy in phonosurgery for glottic insufficiency

Abstract

Purpose

Methods

Results

Conclusion

EASD 2024

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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