Fat Augmentation Following Microsurgical Removal of the Vocal Nodules†
Supported by grant TSGH-C90-39 in Tri-Service General Hospital.
Abstract
Objectives Autogenous fat augmentation has been used as a treatment for glottic insufficiency. However, no information is available on the effectiveness of fat injection in patients with vocal nodules or recurrent vocal nodules after surgery.
Study Design The retrospective study reviews the efficiency of fat injection after surgery in patients with vocal nodules (n = 18) and recurrent vocal nodules (n = 5).
Methods The perceptual acoustic, phonatory function, and video laryngostroboscopic data were evaluated before and after surgery in 23 patients.
Results Mean follow-up time was 7.5 months. Nineteen patients had excellent results. Two patients had improvement, and no change was observed in two patients. Phonatory function showed significant improvement in shimmer, harmonic-to-noiseratio (P <.05), maximum phonation time, grade, roughness, and breathiness (P <.001). Video laryngostroboscopic rating showed significant improvement in linearity of the vocal fold edge, amplitude of vocal fold vibration, and excursion of the mucosal wave (P <.001). Less improvement was observed in recurrent vocal nodules than in nonrecurrent vocal nodules.
Conclusions Fat injection is an effective autogenous implant and may be considered as an option in management of patients with vocal nodules after surgery. Recurrence of nodules is a problem, but the procedure may be repeated.
