Techniques in Vocal Fold Augmentation with Autologous Fat

Abstract

Vocal fold augmentation with autologous fat has been widely applied for management of glottic insufficiency, including vocal fold paresis, vocal fold atrophy, and sulcus vocalis. We describe the techniques in vocal fold augmentation with autologous fat.
1. Tips and actual procedure
1) Fat Tissue: Buccal Fat Pad
2) Injection sites :
With cases of unilateral vocal fold paralysis, the needle should be stuck from posterior at the middle of vocal fold membranous region and the essential point is to increase the volume of the entire vocal fold muscle.
In sulcus vocalis cases, volume is first increased in the shallow part of the muscle layer. The needle is then withdrawn a little and injection proceeds into the lamina propria mucosa.
3) Tool: An electric injector and a 19-G needle, 28cm-long.
2. Evaluation after injection
Autologous fat injection is a relatively safe rehabilitation technique for treating deficiencies in glottal closure. However, excessive use of autologous fat injection can impair voice function. In cases in which there is no improvement in phonation following fat injection, it is important to assess the presence of fat tissues using CT and to determine its effects on wave motion during phonation.