A Study on Fat Tissue used in Vocal Fold Augmentation Surgery

Abstract

In recent years, vocal fold augmentation surgery has been used increasingly as one of the effective rehabilitation operations to treat deficiency of glottal closure in the cases such as unilateral recurrent nerve paralysis.
The fat tissue to be used in this technique has been primarily harvested from the subcutaneous region of the lower abdomen. It is often difficult to obtain sufficient fat tissue for injection due to the physical features of individual patient. For this reason, we have adopted a method to use fat tissue from the buccal fat pad, which is already used in other plastic surgeries.
We evaluated and compared the histological characteristics of fat cells and the condition of vocal folds after injection fat tissue extracted from the subcutaneous region of the lower abdomen and from the buccal fat pad. Our findings were :
(1) The size of buccal fat cells was relatively smaller compared with the size of those taken from abdominal region and was not influenced by BMI. There was less individual difference due to the physical features of the patient.
(2) The number of vascular endothelial cells tended to be higher in buccal fat tissues.
(3) Time until development of mucosal vibration during phonation after surgery was shorter in the cases of buccal fat compared with the cases using abdominal fat.
(4) The percentage of the cases showing continuous effects for 6 months or more was slightly higher in the cases using buccal fat pad.