Long-Term Acoustic Comparison of Thyroplasty versus Autologous Fat Injection

Abstract

The two techniques provided comparable objective acoustic voice improvement. At 2 years, autologous fat injection provides long-term acoustic voice improvement comparable to that of thyroplasty, but it has a higher rate of revision surgery.

Treatment of vocal cord paralysis by autologous fat injection: Our experience with 41 patients

“…Hartl and colleagues also observed that acoustic parameters (eg, jitter and shimmer) reduced quickly after one month of surgery and maintained up to 24 months. 9 Moreover, the index of vocal ageing (ie, harmonics-to-noise ratio) in our study was improved by almost 57% at months 1-3 which was also observed by a previous study. 5 We also found substantial improvement in glottal patency, glottal gap, vocal cord and voice handicap index.…”

“…For instance, a study on 33 patients with UVCP in Taiwan observed that jitter had improved from 2.7 at baseline to 1.3 at month 3, which is comparable with our observed effect size. Hartl and colleagues also observed that acoustic parameters (eg, jitter and shimmer) reduced quickly after one month of surgery and maintained up to 24 months . Moreover, the index of vocal ageing (ie, harmonics‐to‐noise ratio) in our study was improved by almost 57% at months 1‐3 which was also observed by a previous study .…”

Vocal Fold Injection: Review of Indications, Techniques, and Materials for Augmentation

“…Specifically, this has been successfully used to treat vocal fold atrophy, paralysis, paresis, and augmentation after previous framework surgery. Specifically, results with calcium hydroxyapatite (3, 29) and autologous fat injections (30) have proven acceptable in the treatment of atrophy, paralysis, and paresis. Though some have reported inconsistent results with fat when compared to type I thyroplasty in cases of unilateral vocal fold paralysis (10), many may find better results with the ability to "fine tune" serial injections for progressive vocal fold atrophy and presbylarynx.…”

Management of unilateral recurrent laryngeal nerve injury after thyroid surgery: A review

“…With the latter, there is risk of breathing problems as some narrowing of the airway is expected after surgery. Nonrandomized studies looking at injection versus laryngoplasty have shown very similar results in the short‐term and long‐term, although there was a higher rate of revision surgery in the injection group …”

“…Nonrandomized studies looking at injection versus laryngoplasty have shown very similar results in the short-term and long-term, although there was a higher rate of revision surgery in the injection group. [66][67][68][69] There is currently a choice of materials and some of these are listed in Table 3. 51,[70][71][72][73][74][75][76] Poor surgical results may be due to a variety of reasons.…”