Vocal fold injection

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

Bilateral vocal fold immobility/hypomobility, coagulopathy (relative)

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

Check coagulation status if patient is anti-coagulated.

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: 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.

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

None

None

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.