Chen Yen-Yu, Pai Lu, Lin Yaoh-Shiang, Wang Hsing-Won, Hsiung Ming-Wang
Department of Otolaryngology, Tri-Service General Hospital, National Defense Medical Center, No. 325 Cheunggung Road, Sec. 2, Taipei 114, Taiwan, ROC.
ORL J Otorhinolaryngol Relat Spec. 2003 May-Jun;65(3):176-83. doi: 10.1159/000072256.
While autogenous fat augmentation for glottic insufficiency has been used before, relatively little information is currently available on the effectiveness of fat injection in patients with nonparalytic glottic insufficiency resulting from problems such as various defects of vocal atrophy or sulcus vocalis. This paper compares retrospectively the efficiency of fat injection after surgery in patients with vocal atrophy (n = 16) and sulcus vocalis (n = 8). The perceptual acoustic and phonatory functions and videolaryngostroboscopic data were evaluated before and after fat augmentation in 24 patients. The mean follow-up time was 19.5 months. Fifteen patients displayed excellent results; 1 showed some improvement; 6 experienced postprocedure failure, and 2 were not available for follow-up analysis. Perceptual rating showed significant improvement in grade, roughness and breathiness (p < 0.05). The videolaryngostroboscopic rating showed significant improvements in vocal fold edge linearity, vocal fold vibration amplitude and mucosal wave excursion (p < 0.05). More improvement in vocal atrophy was observed compared with sulcus vocalis following fat injection procedures. Our research showed that middle defects improved more compared to those in the anterior and posterior area. Fat injection is an effective autogenous implant and may be considered as an option in the treatment of patients with vocal atrophy or sulcus vocalis. Although fat reabsorption was a problem, repeating the procedure could be considered.
虽然自体脂肪填充治疗声门闭合不全此前已有应用，但目前关于脂肪注射对因声带萎缩或声带沟等各种问题导致的非麻痹性声门闭合不全患者的有效性的信息相对较少。本文回顾性比较了声带萎缩患者（n = 16）和声带沟患者（n = 8）术后脂肪注射的效果。对24例患者在脂肪填充前后的听觉声学、发声功能及电子喉镜频闪喉镜数据进行了评估。平均随访时间为19.5个月。15例患者效果极佳；1例有一定改善；6例术后效果不佳，2例未纳入随访分析。主观评分显示在等级、粗糙度和气息声方面有显著改善（p < 0.05）。电子喉镜频闪喉镜评分显示在声带边缘线性、声带振动幅度和黏膜波偏移方面有显著改善（p < 0.05）。与声带沟患者相比，脂肪注射术后声带萎缩患者改善更明显。我们的研究表明，中部缺损比前部和后部区域改善更明显。脂肪注射是一种有效的自体植入方法，可作为声带萎缩或声带沟患者治疗的一种选择。尽管脂肪吸收是一个问题，但可考虑重复手术。
