Long-term results of autologous fascia in unilateral vocal fold paralysis

Abstract

The objective of this retrospective clinical review was to evaluate the long-term results of injection laryngoplasty with autologous fascia as a single, primary procedure in unilateral vocal fold paralysis. Forty-three patients who had undergone injection laryngoplasty between 1996 and 2003 entered the study. Clinical examination and videostroboscopy were performed and the voice handicap index was analyzed postoperatively. Pre- and post-operative evaluation included computerized acoustic analysis and perceptual evaluation. The results remained stable 3-10 years and were not affected by the length of follow-up, the delay from paralysis to surgery, or the age of the patient. Although most mean values of voice parameters were significantly improved, results in individual patients were difficult to predict. Poor results were especially related to cases caused by intrathoracic lesions. Wide glottal gaps should not be treated with fascia injection. Fascia is a stable graft and most suitable for cases with less severe glottal insufficiency.

Our Experience of Medialization Thyroplasty with Freeze-Dried Cadaveric Human Fascia Lata in Unilateral True Vocal Cord Paralysis

“…In a similar study by Reijonen et al, most voice parameters significantly improved after injection laryngoplasty with autologous fascia (13). In another study by Rihkanen et al, video analysis revealed fewer large glottal gaps after augmentation with autologous fascia (14).…”

“…Use of autologous fascia, harvested from the fascia lata, has been shown to be more effective than other materials (eg, autologous fat, collagen, calcium hydroxylapatite, Gelfoam™, and hyaluronic acid), considering its lower metabolic requirements, more stability, and less susceptibility to resorption (12,13). However, advantages of this material have been less examined in the clinical setting.…”

Injection Laryngoplasty Materials

“…Reijonen ve ark. ise, 3-10 yıl gibi, uzun dönem takipte fasyanın stabil kaldığını tespit etmişlerdir [26].…”

Vocal Fold Injection Augmentation with Novielle Voice Gel

“…Resorption may be an advantage if temporary medialization is required however often over-injection of these substances is necessary to ensure reasonable length of efficacy and can temporarily compromise the airway. Autologous fascia has been used with long-lasting results (3-10yr) but requires separate incision to harvest the fascia 6,7 . Bioplastique is a biphasic combination of solid silicone particles suspended in polyvinylpyrrolidone carrier.…”