Vocal fold paralysis is relatively rare in the pediatric population, and there are few instances of surgical intervention for glottic insufficiency in children. As a result, the pediatric literature on this condition is scarce.
We performed autologous fat injection laryngoplasty for a 9-year-old boy who experienced unilateral vocal fold paralysis. The patient developed dysphonia and aspiration following cardiac surgery at age 3 years. His condition remained unchanged for over 5 years. The left vocal cord was immobile at the paramedian position, and had atrophied. The GRBAS scale was G2R1B2A1S0, and the maximum phonation time (MPT) was 4 seconds.
We obtained a block of autologous fat from the lower abdomen by incision, and divided it into smaller sections. The particles of fat were injected into the left vocal fold by endolaryngeal microsurgery.
After the injection, the patient’s vocal quality improved to G1R1B1A0S0, and the MPT to 8 seconds. The frequency of aspiration also decreased significantly.
Autologous fat injection laryngoplasty is preferable for pediatric unilateral vocal fold paralysis because laryngeal frame surgery can interrupt normal laryngeal growth in puberty. Following this procedure, the patient should be monitored closely for possible airway obstruction. Long-term follow up is also required due to possible fat absorption and the effect of laryngeal growth in puberty.
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