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European Archives of Oto-Rhino-Laryngology

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Open Access 01-07-2019 | Autologous Fat | Laryngology

Bilateral vocal fold injection with autologous fat in patients with vocal fold atrophy with or without sulcus

Authors: Emke M. J. M. van den Broek, Bas J. Heijnen, Martine Hendriksma, Vivienne A. H. van de Kamp-Lam, Antonius P. M. Langeveld, Peter Paul G. van Benthem, Elisabeth V. Sjögren

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2019

Abstract

Purpose

To evaluate voice outcome after bilateral vocal fold injection with autologous fat in patients with non-paralytic glottic insufficiency due to vocal fold atrophy with or without sulcus.

Methods

This is a retrospective cohort study from September 2012 to December 2017 including 23 patients undergoing bilateral vocal fold injection with autologous fat (24 procedures) for vocal fold atrophy (15 procedures) or atrophy with sulcus (Ford type II or III) (9 procedures). Voice data were collected and analyzed for the preoperative and the 3- and 12-month postoperative time points according to a standardized protocol, including Voice Handicap Index (VHI)-30 and perceptive, acoustic and aerodynamic parameters. Failure rate was defined as non-relevant improvement (< 10 points) in VHI-30 at 12 months and number of revisions within 12 months.

Results

There was a clinically relevant (≥ 15 points) and statistically significant improvement in the VHI-30 (preoperative: 49.1 points; postoperative at 12 months: 29.7 points). Change in dynamic range was also statistically significant over time (p = 0.028). There were no differences in voice parameters between patients with atrophy only and atrophy with sulcus, although grade tended to be lower in patients with atrophy only over all time points.

Conclusion

This study shows that bilateral vocal fold injection with autologous fat is a beneficial treatment not only for patients with atrophy but also for patients with sulcus. A comparison of the results with those reported from other forms of sulcus surgery confirmed this finding. However, there is a need for further prospective studies comparing the short- and long-term effects of different techniques.

Van den Broek EMJM, Heijnen BJ, Hendriksma M, Langeveld APM, van Benthem PPG, Sjögren EV (2019) Bilateral trial vocal fold injection with hyaluronic acid in patients with vocal fold atrophy with or without sulcus. Eur Arch Otorhinolaryngol 276(5):1413–1422. https://doi.org/10.1007/s00405-019-05347-2 CrossRefPubMedPubMedCentral

Ford CN, Inagi K, Khidr A, Bless DM, Gilchrist KW (1996) Sulcus vocalis: a rational analytical approach to diagnosis and management. Ann Otol Rhinol Laryngol 105(3):189–200. https://doi.org/10.1177/000348949610500304 CrossRefPubMed

Bouchayer M, Cornut G, Witzig E, Loire R, Roch JB, Bastian RW (1985) Epidermoid cysts, sulci, and mucosal bridges of the true vocal cord: a report of 157 cases. Laryngoscope 95(9 Pt 1):1087–1094PubMed

Friedrich G, Dikkers FG, Arens C, Remacle M, Hess M, Giovanni A, Duflo S, Hantzakos A, Bachy V, Gugatschka M (2013) Vocal fold scars: current concepts and future directions. Consensus report of the Phonosurgery Committee of the European Laryngological Society. Eur Arch Oto-rhino-laryngol 270(9):2491–2507. https://doi.org/10.1007/s00405-013-2498-9 CrossRef

Overton L, Adams K, Shah RN, Buckmire RA (2017) Longitudinal voice outcomes after type I Gore-Tex thyroplasty for nonparalytic glottic incompetence. Ann Otol Rhinol Laryngol 126(1):14–19. https://doi.org/10.1177/0003489416672475 CrossRefPubMed

Jacobson BHJA, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, Newman GW (1997) The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 6(3):4CrossRef

Hakkesteegt MM, Wieringa MH, Gerritsma EJ, Feenstra L (2006) Reproducibility of the Dutch version of the Voice Handicap Index. Folia Phoniatr Logop 58(2):132–138. https://doi.org/10.1159/000089613 CrossRefPubMed

Van Gogh CD, Mahieu HF, Kuik DJ, Rinkel RN, Langendijk JA, Verdonck-de Leeuw IM (2007) Voice in early glottic cancer compared to benign voice pathology. Eur Arch Otorhinolaryngol 264(9):1033–1038. https://doi.org/10.1007/s00405-007-0313-1 CrossRefPubMed

Isshiki N, Okamura H, Tanabe M, Morimoto M (1969) Differential diagnosis of hoarseness. Folia Phoniatr 21(1):9–19CrossRef

10.

Beunckens C, Molenberghs G, Kenward MG (2005) Direct likelihood analysis versus simple forms of imputation for missing data in randomized clinical trials. Clin Trials (London, England) 2(5):379–386. https://doi.org/10.1191/1740774505cn119oa CrossRef

11.

Wuyts FL, De Bodt MS, Molenberghs G, Remacle M, Heylen L, Millet B, Van Lierde K, Raes J, Van de Heyning PH (2000) The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach. J Speech Lang Hear Res JSLHR 43(3):796–809CrossRefPubMed

12.

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/10.1177/0003489415595427 CrossRefPubMed

13.

Zeitels SM, Mauri M, Dailey SH (2003) Medialization laryngoplasty with Gore-Tex for voice restoration secondary to glottal incompetence: indications and observations. Ann Otol Rhinol Laryngol 112(2):180–184. https://doi.org/10.1177/000348940311200213 CrossRefPubMed

14.

Hsiung MW, Woo P, Minasian A, Schaefer Mojica J (2000) Fat augmentation for glottic insufficiency. Laryngoscope 110(6):1026–1033. https://doi.org/10.1097/00005537-200006000-00026 CrossRefPubMed

15.

Cantarella G, Mazzola RF, Gaffuri M, Iofrida E, Biondetti P, Forzenigo LV, Pignataro L, Torretta S (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/10.1177/0194599817739256 CrossRefPubMed

16.

Lodder WL, Dikkers FG (2015) Comparison of voice outcome after vocal fold augmentation with fat or calcium hydroxylapatite. Laryngoscope 125(5):1161–1165. https://doi.org/10.1002/lary.25104 CrossRefPubMed

17.

Dursun G, Boynukalin S, Ozgursoy OB, Coruh I (2008) Long-term results of different treatment modalities for glottic insufficiency. Am J Otolaryngol 29(1):7–12. https://doi.org/10.1016/j.amjoto.2006.12.001 CrossRefPubMed

18.

Zelenik K, Walderova R, Kucova H, Jancatova D, Kominek P (2017) Comparison of long-term voice outcomes after vocal fold augmentation using autologous fat injection by direct microlaryngoscopy versus office-based calcium hydroxylapatite injection. Eur Arch Otorhinolaryngol 274(8):3147–3151. https://doi.org/10.1007/s00405-017-4600-1 CrossRefPubMed

19.

Dominguez ML, Villarreal R, Simpson CB (2018) Voice outcomes of lipoinjection versus medialization laryngoplasty for nonparalytic glottic insufficiency. Laryngoscope 129:1164. https://doi.org/10.1002/lary.27573 CrossRef

20.

Neuenschwander MC, Sataloff RT, Abaza MM, Hawkshaw MJ, Reiter D, Spiegel JR (2001) Management of vocal fold scar with autologous fat implantation: perceptual results. J Voice 15(2):295–304. https://doi.org/10.1016/s0892-1997(01)00031-5 CrossRefPubMed

21.

Sanderson JD, Simpson CB (2009) Laryngeal complications after lipoinjection for vocal fold augmentation. Laryngoscope 119(8):1652–1657. https://doi.org/10.1002/lary.20529 CrossRefPubMed

22.

Chen YY, Pai L, Lin YS, Wang HW, Hsiung MW (2003) Fat augmentation for nonparalytic glottic insufficiency. ORL 65(3):176–183. https://doi.org/10.1159/000072256 CrossRefPubMed

23.

Hsiung MW, Lin YS, Su WF, Wang HW (2003) Autogenous fat injection for vocal fold atrophy. Eur Arch Otorhinolaryngol 260(9):469–474. https://doi.org/10.1007/s00405-003-0622-y CrossRefPubMed

24.

Hsiung MW, Chen YY, Pai L, Lin CJ, Wang HW (2003) Results of magnetic resonance imaging assessment, acoustic analysis, phonatory function and perceptual rating of glottic insufficiency before and after fat augmentation: correlated with subjective rating. ORL 65(2):76–83. https://doi.org/10.1159/000070770 CrossRefPubMed

25.

Stuut M, Tjon Pian Gi RE, Dikkers FG (2014) Change of Voice Handicap Index after treatment of benign laryngeal disorders. Eur Arch Otorhinolaryngol 271(5):1157–1162. https://doi.org/10.1007/s00405-013-2773-9 CrossRefPubMed

26.

Arffa RE, Krishna P, Gartner-Schmidt J, Rosen CA (2012) Normative values for the Voice Handicap Index-10. J Voice 26(4):462–465. https://doi.org/10.1016/j.jvoice.2011.04.006 CrossRefPubMed

27.

Karle WE, Helman SN, Cooper A, Zhang Y, Pitman MJ (2018) Temporalis fascia transplantation for sulcus vocalis and vocal fold scar: long-term outcomes. Ann Otol Rhinol Laryngol 127(4):223–228. https://doi.org/10.1177/0003489417753224 CrossRefPubMed

28.

Gonzalez-Herranz R, Hernandez Garcia E, Granda-Rosales M, Eisenberg-Plaza G, Montojo Woodeson J, Plaza G (2018) Improved mucosal wave in unilateral autologous temporal fascia graft in sulcus vocalis type 2 and vocal scars. J Voice. https://doi.org/10.1016/j.jvoice.2018.06.013 CrossRefPubMed

29.

Yilmaz T (2012) Sulcus vocalis: excision, primary suture and medialization laryngoplasty: personal experience with 44 cases. Eur Arch Otorhinolaryngol 269(11):2381–2389. https://doi.org/10.1007/s00405-012-2058-8 CrossRefPubMed

30.

Miaskiewicz B, Szkielkowska A, Gos E, Panasiewicz A, Wlodarczyk E, Skarzynski PH (2018) Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients. Eur Arch Otorhinolaryngol 275(11):2763–2771. https://doi.org/10.1007/s00405-018-5040-2 CrossRefPubMedPubMedCentral

31.

Hsiung MW, Kang BH, Pai L, Su WF, Lin YH (2004) Combination of fascia transplantation and fat injection into the vocal fold for sulcus vocalis: long-term results. Ann Otol Rhinol Laryngol 113(5):359–366. https://doi.org/10.1177/000348940411300504 CrossRefPubMed

32.

Hwang CS, Lee HJ, Ha JG, Cho CI, Kim NH, Hong HJ, Choi HS (2013) Use of pulsed dye laser in the treatment of sulcus vocalis. Otolaryngol Head Neck Surg 148(5):804–809. https://doi.org/10.1177/0194599813479909 CrossRefPubMed

33.

Mortensen MM, Woo P, Ivey C, Thompson C, Carroll L, Altman K (2008) The use of the pulse dye laser in the treatment of vocal fold scar: a preliminary study. Laryngoscope 118(10):1884–1888. https://doi.org/10.1097/MLG.0b013e31817d7546 CrossRefPubMed

34.

Park YM, Lim JY, Kang MS, Choi HS (2019) Treatment outcomes of angiolytic laser-assisted glottoplasty in patients with sulcus vocalis. Ann Otol Rhinol Laryngol. https://doi.org/10.1177/0003489419826132 CrossRefPubMed

35.

Welham NV, Choi SH, Dailey SH, Ford CN, Jiang JJ, Bless DM (2011) Prospective multi-arm evaluation of surgical treatments for vocal fold scar and pathologic sulcus vocalis. Laryngoscope 121(6):1252–1260. https://doi.org/10.1002/lary.21780 CrossRefPubMedPubMedCentral

Title: Bilateral vocal fold injection with autologous fat in patients with vocal fold atrophy with or without sulcus
Authors: Emke M. J. M. van den Broek
Bas J. Heijnen
Martine Hendriksma
Vivienne A. H. van de Kamp-Lam
Antonius P. M. Langeveld
Peter Paul G. van Benthem
Elisabeth V. Sjögren
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Keyword: Autologous Fat
Published in: European Archives of Oto-Rhino-Laryngology / Issue 7/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05479-5

At a glance: The STEP trials

Springer Medicine

Bilateral vocal fold injection with autologous fat in patients with vocal fold atrophy with or without sulcus

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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