Hsiung M W, Woo P, Minasian A, Schaefer Mojica J
Department of Otolaryngology--Head and Neck Surgery, The Mount Sinai Hospital, The Grabscheid Voice Center, New York, New York 10029-6574, USA.
Laryngoscope. 2000 Jun;110(6):1026-33. doi: 10.1097/00005537-200006000-00026.
Fat lipoinjection augmentation for glottic insufficiency has been used in patients with vocal fold paralysis. Relatively little information is available on the effectiveness of fat injection in patients with vocal atrophy, intubation trauma, and post-hemilaryngectomy defects.
This paper retrospectively compares the efficiency of fat injection in patients with vocal cord paralysis (n = 9), vocal scar (n = 13), and vocal atrophy (n = 11).
The perceptual acoustic, phonatory function, and videolaryngostroboscopic data were evaluated before and after fat augmentation in 33 patients.
Mean follow-up time was 9.7 months. Nineteen patients had excellent results. Three patients had no change. Five patients had late failure. Six patients were lost to follow-up. Phonatory function showed significant improvement in jitter, shimmer, noise-to-harmonic ratio, maximal phonation time, grade, asthenia, and breathiness (P < .05). Videolaryngostroboscopic rating showed significant improvement in right linearity of the vocal fold edge, amplitude of vocal fold vibration, excursion of the mucosal wave, vibratory behavior, and phase symmetry (P < .05). Anterior defects did better than posterior defects. Small vocal fold defects did better than large defects.
Fat injection is a good autogenous implant and may be considered as an option in management of patients with vocal fold scar, defect, or atrophy. Reabsorption of fat is a problem, but the procedure may be repeated.
脂肪注射填充术用于声门功能不全患者，已应用于声带麻痹患者。关于脂肪注射在声带萎缩、插管创伤和半喉切除术后缺损患者中的有效性，相关信息相对较少。
本文回顾性比较了脂肪注射在声带麻痹患者（n = 9）、声带瘢痕患者（n = 13）和声带萎缩患者（n = 11）中的效果。
对33例患者脂肪填充前后的听觉感知、发声功能和电子喉镜频闪检查数据进行评估。
平均随访时间为9.7个月。19例患者效果极佳。3例患者无变化。5例患者后期效果不佳。6例患者失访。发声功能在抖动、闪烁、噪声谐波比、最大发声时间、分级、乏力和呼吸音方面有显著改善（P < .05）。电子喉镜频闪检查评分在声带边缘右线性、声带振动幅度、黏膜波偏移、振动行为和相位对称性方面有显著改善（P < .05）。前部缺损比后部缺损效果好。小的声带缺损比大的缺损效果好。
脂肪注射是一种良好的自体植入物，可作为声带瘢痕、缺损或萎缩患者治疗的一种选择。脂肪吸收是一个问题，但该手术可重复进行。
