Augmentation Autologous Adipose Injections in the Larynx

Abstract

Objective: Autologous adipose injection (AAI) is a recognized method for vocal fold augmentation. The study’s purpose is to explore short- and long-term outcomes of AAI. Methods: Retrospective chart review of 43 patients undergoing AAI was performed; patient perception of outcome, Voice Handicap Index (VHI), maximum phonatory time (MPT), and disposition were evaluated. Results: Over 5 years, 43 AAI patients had documented postoperative follow-up (25 paralysis, 8 paresis, 9 bowing/presbylarynges, and 5 scar/sulci). Mean follow-up was 32 weeks. There was gradual patient loss to follow-up. Thirty-nine of 40 (98%) had patient-reported improvement at 6 weeks, 28 of 34 (82%) had improvement at 2 to 6 months, with 10 of 12 (83%) sustaining their improvement for >1 year. Significant improvement in mean VHI was observed at 4 to 6 weeks (mean reduction, 26; P < .0001) and 2 to 6 months (mean reduction, 23; P < .0001). Improvement in mean MPT was observed at 4 to 6 weeks (mean increase, 8 s; P < .0001), 2 to 6 months (6 s; P = .007), and >1 year (4 s; P = .03). Eight patients went on to medialization laryngoplasty. Conclusion: AAI successfully augments vocal folds in short-term outcomes with some gradual decrease in effectiveness. Although patient attrition limited conclusions, objective long-term benefit may occur in >50% of patients.