Autologous Lipoaugmentation Long‐Term Clinical Outcomes: A Systematic Review

Abstract

Objectives/Hypothesis Vocal fold (VF) lipoaugmentation can be employed to treat glottal insufficiency although variable data exist on its length of effectiveness. We aimed to review published long‐term outcomes following lipoaugmentation across the literature and compile outcome data. Study Design Systematic review. Methods A systematic search in September 2020 of PubMed, MEDLINE, Cochrane Library, and Web of Science used the Preferred Reporting Items for Systematic Review and Meta‐Analyses guidelines to identify 128 relevant articles related to VF lipoaugmentation effectiveness duration. Primary search terms included the following: vocal cord, fat, lipo, and atrophy. Forty‐eight full‐text articles were reviewed and 31 were included in the final analysis. Primary endpoints included the following: duration of effectiveness per patient‐reported outcome measures, objective findings, and additional procedures performed. In addition, fat harvest location and processing techniques were recorded. Findings Thirty‐one studies totaling 764 patients were included in the review. Indications for augmentation were VF paralysis (N = 690) and atrophy (N = 74). Fat was harvested from the abdominal region in 21 studies (529 patients), the thigh/abdomen in 5 studies (91 patients), and buccal/submental region in 2 studies (33 patients). Processing techniques and injectable volume varied. Across included studies, only 11 of 764 patients (1.4%) reported no improvement in voice and/or swallowing. Within the first year, 71 of 608 patients (11.7%) reported a regression toward baseline. Beyond 1 year and up to 8 years, 27 of 214 patients (12.6%) reported regression from initial improvement. Thirty‐three patients underwent additional procedures. Conclusion Although improvements in voice and swallowing after lipoaugmentation taper over time, most patients experienced long‐term benefit. Laryngoscope, 132:1042–1053, 2022