Vocal Fold Lipoinjection

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Author: R. Jun Lin
Published:
Specialties: Otolaryngology
Schools: University of Pittsburgh Voice Center
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Basic Info

Contributor: VyVy N. Young and Clark A. Rosen

Lipoinjection of the vocal folds results in medialization and augmentation of the vocal folds by deposition of autologous fat.

Editor Recruited By: Michael Johns, III, MD

DOI: http://dx.doi.org/10.17797/ngjuxe20iq

Advanced

Procedure

Vocal fold injection

Indications

Vocal fold paralysis, vocal fold paresis, vocal fold atrophy, sulcus vocalis, severe vocal fold scar, soft tissue loss of the vocal fold(s)

Contraindications

Bilateral vocal fold immobility/hypomobility, coagulopathy (relative)

Instrumentation

Setup

General anesthesia and endotracheal intubation; liposuction is performed after sterile prep and draping; microsuspension laryngoscopy can be performed as a clean procedure.

Preoperative Workup

Check coagulation status if patient is anti-coagulated.

Anatomy and Landmarks

Make a 5mm abdominal incision in the right lower quadrant of the abdomen. Aim liposuction cannula opening upwards in the subcutaneous plane to prevent accidental penetration into deep abdominal contents.

Advantages/Disadvantages

Advantages: provides a large amount of autologous injectable material, less invasive compared to a medialization laryngoplasty, expedient.
Disadvantages: 10-15% revision rate due to fat resorption.

Complications/Risks

Airway obstruction, infection and/or hematoma at the abdominal liposuction site, overinjection, underinjection, fat resorption requiring revision surgery.

Disclosure of Conflicts

None

Acknowledgements

None

References

Rosen CA and Simpson CB (2008). Operative Techniques in Laryngology. Chapter 31. Vocal Fold Augmentation - via Direct Microlaryngoscopy. Pages 200-202. Springer, Berlin.
Cantarella G, Mazzola RF, Domenichini E, Arnour F, Maraschi B (2005) Vocal fold augmentation by autologous fat injection with lipostructure procedure. Otolaryngol Head Neck Surg 132: 239-243.
Hsiung MW, Lin YS, Su FW, Wang HW (2003) Autogenous fat injection for vocal fold atrophy. Eur Arch Otorhinolaryngol 260: 469-474.
Laccourreye O et al (2003) Intracordal injection of autologous fat in patients with unilateral laryngeal nerve paralysis, long-term results from the patient's perspective. Laryngoscope 113: 541-545.

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