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Efficacy of trans-nasal fiberendoscopic injection laryngoplasty with centrifuged autologous fat in the treatment of glottic insufficiency due to unilateral vocal fold paralysis.
Acta Otorhinolaryngol Ital. 2018 Jun; 38(3):204-213.AO

Abstract

SUMMARY

The objective of this work is to evaluate the safety, feasibility and efficacy of trans-nasal fiberendoscopic injection laryngoplasty (IL) with centrifuged autologous fat, performed under local anaesthesia, in the treatment of glottic insufficiency due to unilateral vocal fold paralysis (UVFP). It is a within-subject study with follow-up 1 week after phonosurgery and after 6 months. A total of 22 patients with chronic dysphonia caused by glottic insufficiency due to UVFP were enrolled. Each patient underwent trans-nasal IL with centrifuged autologous fat through flexible operative endoscope under local anaesthesia and was evaluated before and twice (1 week and 6 months) after phonosurgery, using a multidimensional set of investigations. The assessment protocol included videolaryngostroboscopy, perceptual evaluation of dysphonia, maximum phonation time and patient's self-assessment on voice-related quality of life (QOL) with the Voice Handicap Index-10 and the comparative self-assessment on vocal fatigue and voice quality pre-post treatment. Trans-nasal IL with centrifuged autologous fat was performed in all 22 patients and there were no complications in any case. Significant improvements in videolaryngostroboscopic findings, perceptual evaluation of dysphonia, maximum phonation time and QoL self-assessment were reported after 1 week and were maintained at 6 months. In one patient, the result after 6 months was not satisfactory and this patient then underwent a medialization laryngoplasty (thyroplasty type I) with satisfactory long-term results. In conclusion, trans-nasal fiberendoscopic IL with centrifuged autologous fat seems to be a safe, feasible and efficacious phonosurgical procedure for treatment of glottic insufficiency due to unilateral vocal fold paralysis.

Authors+Show Affiliations

ENT Department, M. Bufalini Hospital, Cesena, Italy.ENT Department, M. Bufalini Hospital, Cesena, Italy.Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy.Department of Biomedical and Clinical Sciences, L. Sacco Hospital, University of Milan, Milan, Italy.ENT Clinic, University of Messina, Messina, Italy.Medical Center of Phoniatrics and Phonosurgery, Padua, Italy.Clinical Professor, Department Of Otolaryngology Head and Neck Surgery, Icahn School of Medicine, New York, USA.Department of Otorhinolaryngology Head and Neck Surgery, Centre Hospitalier Luxemburg, Luxemburg.ENT Department, M. Bufalini Hospital, Cesena, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29984796

Citation

Ricci Maccarini, A, et al. "Efficacy of Trans-nasal Fiberendoscopic Injection Laryngoplasty With Centrifuged Autologous Fat in the Treatment of Glottic Insufficiency Due to Unilateral Vocal Fold Paralysis." Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-facciale, vol. 38, no. 3, 2018, pp. 204-213.
Ricci Maccarini A, Stacchini M, Mozzanica F, et al. Efficacy of trans-nasal fiberendoscopic injection laryngoplasty with centrifuged autologous fat in the treatment of glottic insufficiency due to unilateral vocal fold paralysis. Acta Otorhinolaryngol Ital. 2018;38(3):204-213.
Ricci Maccarini, A., Stacchini, M., Mozzanica, F., Schindler, A., Basile, E., DE Rossi, G., Woo, P., Remacle, M., & Magnani, M. (2018). Efficacy of trans-nasal fiberendoscopic injection laryngoplasty with centrifuged autologous fat in the treatment of glottic insufficiency due to unilateral vocal fold paralysis. Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-facciale, 38(3), 204-213. https://doi.org/10.14639/0392-100X-2012
Ricci Maccarini A, et al. Efficacy of Trans-nasal Fiberendoscopic Injection Laryngoplasty With Centrifuged Autologous Fat in the Treatment of Glottic Insufficiency Due to Unilateral Vocal Fold Paralysis. Acta Otorhinolaryngol Ital. 2018;38(3):204-213. PubMed PMID: 29984796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of trans-nasal fiberendoscopic injection laryngoplasty with centrifuged autologous fat in the treatment of glottic insufficiency due to unilateral vocal fold paralysis. AU - Ricci Maccarini,A, AU - Stacchini,M, AU - Mozzanica,F, AU - Schindler,A, AU - Basile,E, AU - DE Rossi,G, AU - Woo,P, AU - Remacle,M, AU - Magnani,M, PY - 2017/11/19/received PY - 2018/01/11/accepted PY - 2018/7/10/entrez PY - 2018/7/10/pubmed PY - 2019/3/2/medline KW - Autologous fat injection KW - Injection laryngoplasty KW - Phonosurgery under local anaesthesia KW - Trans-nasal fiberendoscopic phonosurgery KW - Vocal fold paralysis SP - 204 EP - 213 JF - Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale JO - Acta Otorhinolaryngol Ital VL - 38 IS - 3 N2 - SUMMARY: The objective of this work is to evaluate the safety, feasibility and efficacy of trans-nasal fiberendoscopic injection laryngoplasty (IL) with centrifuged autologous fat, performed under local anaesthesia, in the treatment of glottic insufficiency due to unilateral vocal fold paralysis (UVFP). It is a within-subject study with follow-up 1 week after phonosurgery and after 6 months. A total of 22 patients with chronic dysphonia caused by glottic insufficiency due to UVFP were enrolled. Each patient underwent trans-nasal IL with centrifuged autologous fat through flexible operative endoscope under local anaesthesia and was evaluated before and twice (1 week and 6 months) after phonosurgery, using a multidimensional set of investigations. The assessment protocol included videolaryngostroboscopy, perceptual evaluation of dysphonia, maximum phonation time and patient's self-assessment on voice-related quality of life (QOL) with the Voice Handicap Index-10 and the comparative self-assessment on vocal fatigue and voice quality pre-post treatment. Trans-nasal IL with centrifuged autologous fat was performed in all 22 patients and there were no complications in any case. Significant improvements in videolaryngostroboscopic findings, perceptual evaluation of dysphonia, maximum phonation time and QoL self-assessment were reported after 1 week and were maintained at 6 months. In one patient, the result after 6 months was not satisfactory and this patient then underwent a medialization laryngoplasty (thyroplasty type I) with satisfactory long-term results. In conclusion, trans-nasal fiberendoscopic IL with centrifuged autologous fat seems to be a safe, feasible and efficacious phonosurgical procedure for treatment of glottic insufficiency due to unilateral vocal fold paralysis. SN - 1827-675X UR - https://www.unboundmedicine.com/medline/citation/29984796/Efficacy_of_trans_nasal_fiberendoscopic_injection_laryngoplasty_with_centrifuged_autologous_fat_in_the_treatment_of_glottic_insufficiency_due_to_unilateral_vocal_fold_paralysis_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/29984796/ DB - PRIME DP - Unbound Medicine ER -