Objectives: Since 1997, we have performed the autologous transplantation of fascia into the vocal fold (ATFV) procedure on cases of sulcus vocalis. In what follows, we report the long‐term results of our new surgical approach and discuss the role of these transplantations. We also review and report some complications that can be caused by ATFV. Finally, we discuss the ATFV technique as a contribution to the phonosurgery of the future.
Study Design: Prospective study.
Methods: We were able to obtain long‐term results from 10 volunteer cases (2 female and 8 male, age: 15–71, mean 46.5 years old) who could be followed up for at least 3 years after transplantation. All were cases of pathologic sulcus vocalis.
We measured maximum phonation time (MPT) and carried out pre‐ and postsurgical clinical observation and laryngeal stroboscopy in all cases. These measurements and observations were made before the ATFV and at 6 months, 1 year, 2 years, and 3 years after surgery.
Results: In stroboscopic observation 1 year after the ATFV, satisfactory glottal closure and excellent mucosal wave were observed for all cases, and there was no case with hyperadduction of the false vocal folds. MPT measures remained at an improved level 2 years and 3 years after the transplantations. Paired‐sample t tests showed that the improvement relative to preATFV levels was significant for all postsurgical measurements up to 3 years.
Conclusions: We conclude that ATFV is a successful surgical procedure for sulcus vocalis and scarred vocal folds. Other phonosurgical clinical applications may also be envisioned.
Many surgical approaches have been developed for the treatment of adduction-type spasmodic dysphonia (SPD). We developed and performed a new type of surgical approach (autologous replacement of the vocal fold). Our new surgical technique increases the advantages and decreases the disadvantages of previous surgical procedures in three ways: (1) It has similar effects to the previous procedures in that it prevents contraction of the thyroarytenoid muscle. (2) It decreases vocal-fold tension, as in framework surgery. (3) It reduces glottal incompetence, as does fibrinogen-glue injection, but it is more suitable because it is autologous. Furthermore, it produces increases in the mass and volume of the vocal-fold body and is also safe because the replacement tissue is autologous. The short-term results appear encouraging in preventing spastic voice while also avoiding vocal-fold atrophy. Long-term follow up will be necessary to determine the actual efficacy. However, this is clearly a possible choice as a surgical approach for treating adduction-type SPD.
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