Document Detail


Outcomes of structural fat grafting for paralytic and non-paralytic dysphonia.
MedLine Citation:
PMID:  22064781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aims of this prospective study were to evaluate the results of vocal fold structural fat grafting for glottic insufficiency and to compare the outcomes obtained in unilateral vocal fold paralysis (UVFP) and congenital or acquired soft tissue defects in vocal folds. Sixty-six consecutive patients with breathy dysphonia, in 43 cases (aged 16-79 years) related to UVFP and in 23 cases (aged 16-67 years) related to vocal fold iatrogenic scar or sulcus vocalis, underwent autologous structural fat grafting into vocal folds. Lipoaspirates were centrifuged at 1200 g for 3 min to separate and remove blood, cell debris and the oily layer. The refined fat was injected under direct microlaryngoscopy in a multilayered way. The main outcome measures were grade, roughness, breathiness, asthenicity and strain (GRBAS) perceptual evaluation, maximum phonation time (MPT), self-assessed Voice Handicap Index (VHI), and voice acoustic analysis, considered pre-operatively and at 3 and 6 months after fat grafting. After surgery, MPT, VHI, G and B improved in both groups (p < 0.05). In particular, G and VHI functional subscales showed a significantly greater decrease in patients with UVFP (p < 0.05). The acoustic variables improved significantly only in the UVFP group (p < 0.005). From 3 to 6 months postoperatively, most variables showed a trend with further improvement. Vocal fold structural fat grafting was significantly effective in treating glottic insufficiency due to UVFP or soft tissue defects. Perceptual, acoustic and subjective assessments confirmed that patients with UVFP had better outcomes than those with soft tissue defects.
Authors:
G Cantarella; G Baracca; S Forti; M Gaffuri; R F Mazzola
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale     Volume:  31     ISSN:  1827-675X     ISO Abbreviation:  Acta Otorhinolaryngol Ital     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-11-08     Completed Date:  2012-03-09     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  8213019     Medline TA:  Acta Otorhinolaryngol Ital     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  154-60     Citation Subset:  IM    
Affiliation:
Otolaryngology Department, Fondazione IRCCS Ca’ Granda Maggiore Policlinico Hospital, Milan, Italy. giovanna.cantarella@policlinico.mi.it
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MeSH Terms
Descriptor/Qualifier:
Abdominal Fat / transplantation*
Dysphonia / etiology*,  surgery*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies
Treatment Outcome
Vocal Cord Paralysis / complications*
Comments/Corrections

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