Randomised clinical trial: Effect of administering platelet-rich fibrin to autologous fat tissue in injection laryngoplasty for vocal cord paralysis

Objectives Autologous fat injection for unilateral vocal cord paralysis is a popular procedure for immediate symptoms control, but uneven long-term outcomes were reported. Most authors believed that the continual resorption of injected fat was the cause of voice degradation. A long-term residual fat volume was evaluated. Methods We retrospectively reviewed the patients following autologous fat injection for symptomatic unilateral vocal cord paralysis from 2002 Aug to 2006 July. The patients accepted head and neck computed tomogragphy (CT) evaluation following surgery were included. A three-dimensional reconstruction of the images of larynx and upper airway was performed on the work station (Vitrea® 2, version 3.9). The volume of intracordal fat was then calculated. Results 5 males and 15 females of the mean age 49 were enrolled. The mean duration from lipoinjection surgery to the CT study is 23.0 months (12–50 months). The injection fat was found in all study cases. The estimated fat volume ranged from 0.01 to 0.75 ml with a mean 0.33 ml. Compare with the injected fat volume, a mean 27.5% fat survived. The correlation between residual fat volume rate and duration of follow-up is not significant. Conclusions The intracordal fat volume didn't decline from time. Long-term intracordal injected fat diminished but survived in all cases. The degradation may be caused by absorption or immediate extrusion from injection wound. An over-correction and prevention of extrusion postoperatively would improve the long-term outcomes.

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Minimally invasive injection laryngoplasty in the management of unilateral vocal cord paralysis after video-assisted mediastinal lymph adenectomy

Videosurgery and Other Miniinvasive Techniques ◽

10.5114/wiitm.2018.75886 ◽

2018 ◽

Vol 13 (3) ◽

pp. 388-393 ◽

Cited By ~ 1

Author(s):

H. Volkan Kara ◽

Aysegul Batioglu Karaaltin ◽

Ezel Ersen ◽

Elvin Alaskarov ◽

Burcu Kilic ◽

...

Keyword(s):

Minimally Invasive ◽

Vocal Cord ◽

Vocal Cord Paralysis ◽

Injection Laryngoplasty ◽

Video Assisted ◽

Unilateral Vocal Cord Paralysis

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Efficacy of autologous fat injection laryngoplasty with an adenoviral vector expressing hepatocyte growth factor in a canine model

The Journal of Laryngology & Otology ◽

10.1017/s0022215109005040 ◽

2009 ◽

Vol 123 (S31) ◽

pp. 24-29 ◽

Cited By ~ 6

Author(s):

H Umeno ◽

S Chitose ◽

Y Murofushi ◽

K Kosai ◽

K Sato ◽

...

Keyword(s):

Electron Microscopy ◽

Growth Factor ◽

Hepatocyte Growth Factor ◽

Adenoviral Vector ◽

Vocal Fold ◽

Injection Laryngoplasty ◽

Fat Tissue ◽

Fat Injection ◽

Autologous Fat ◽

Hepatocyte Growth

AbstractObjective:The effectiveness of autologous fat injection laryngoplasty may be reduced by resorption of injected fat tissue. The aim of the present study was to clarify the efficacy of fat injection laryngoplasty using autologous fat plus a replication-defective adenoviral vector expressing hepatocyte growth factor, regarding reduction of injected fat tissue resorption.Material and methods:Four female beagle dogs were used in this study. After sedation, a direct laryngoscope was introduced to enable visualisation of the larynx. In each dog, harvested autologous fat plus an adenoviral vector expressing hepatocyte growth factor was injected into the right true vocal fold, and harvested fat plus an adenoviral vector expressing no gene was injected into the left true vocal fold. A total laryngectomy was performed one year after the intracordal fat injection. Coronal sections of the resected whole larynges were made and the following parameters assessed using light and electron microscopy: size of fat area; number of vasculoendothelial cells surrounding adipocytes; and shape of injected adipocytes in the vocal fold.Results:The fat area was significantly larger and the number of vasculoendothelial cells surrounding adipocytes significantly greater in the intracordal fat injection containing adenoviral vector expressing hepatocyte growth factor, compared with the control intracordal fat injection containing adenoviral vector expressing no gene. When viewed under electron microscopy, the injected adipocytes were observed to have grafted better in the intracordal fat injection with hepatocyte growth factor adenoviral vector, compared with the control intracordal fat injection with adenoviral vector expressing no gene.Conclusions:Injection into the vocal fold of autologous fat containing an adenoviral vector expressing hepatocyte growth factor can reduce subsequent resorption of injected fat.

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