Hsiung Ming-Wang, Pai Lu
Department of Otolaryngology, Tri-Service General Hospital, Taipei, Taiwan.
Acta Otolaryngol. 2006 Feb;126(2):191-6. doi: 10.1080/00016480500339854.
Our data confirm that fat injection (FI) is a safe, useful, thorough and experience-dependent procedure. It should be considered as a potential treatment protocol for patients with vocal fold atrophy (VFA) and sulcus vergeture (SVER). To increase the chances of excellent phonatory results for sulcus vocalis (SV) patients, our recommended surgical option is FI with fascia transplantation.
To investigate prognostic factors in patients with glottic insufficiency following FI.
The study sample comprised 101 patients treated for VFA (n=31), SVER (n=41) and SV (n=29). A retrospective analysis was performed by means of patient self-assessments, employing multiple logistic regressions for the four independent factors of age, gender, diagnosis and time-frame of surgery.
The mean follow-up time was 16.8 months (range 5-38 months). Immediate complications included hematoma of the donor site in two patients and fat extrusion at the injection site in three. The results of treatment were "excellent" in 48.4% (15/31) of VFA cases, 43.9% (18/41) of SVER cases and 20.7% (6/29) of SV cases, with 19.4% (6/31), 24.4% (10/41) and 55.2% (16/29), respectively reporting improvement and 32.3% (10/31), 31.7% (13/41) and 24.1% (7/29), respectively reporting no improvement. Disease type was determined to have a significant bearing (p=0.025) on treatment effectiveness and patients operated on most recently were shown to have a 4.3-times greater chance of achieving successful results (p<0.01). Multiple logistic regression analysis indicated that VFA and SVER sufferers (as compared to those with SV) and men (as opposed to women) were more likely to achieve an "excellent" result: 3.4, 3.3 and 3.6 times, respectively.
我们的数据证实，脂肪注射（FI）是一种安全、有用、彻底且依赖经验的手术。对于声带萎缩（VFA）和沟状声带（SVER）患者，应将其视为一种潜在的治疗方案。为提高声带沟（SV）患者获得优异发声效果的几率，我们推荐的手术方案是带筋膜移植的脂肪注射。
研究脂肪注射后声门功能不全患者的预后因素。
研究样本包括101例接受治疗的VFA患者（n = 31）、SVER患者（n = 41）和SV患者（n = 29）。通过患者自我评估进行回顾性分析，对年龄、性别、诊断和手术时间框架这四个独立因素采用多元逻辑回归分析。
平均随访时间为16.8个月（范围5 - 38个月）。即刻并发症包括2例供区血肿和注射部位3例脂肪挤出。治疗结果在VFA病例中48.4%（15/31）为“优秀”，SVER病例中43.9%（18/41）为“优秀”，SV病例中20.7%（6/29）为“优秀”，分别有19.4%（6/31）、24.4%（10/41）和55.2%（16/29）报告有改善，32.3%（10/31）、31.7%（13/41）和24.1%（7/29）报告无改善。疾病类型被确定对治疗效果有显著影响（p = 0.025），且最近接受手术的患者取得成功结果的几率高4.3倍（p < 0.01）。多元逻辑回归分析表明，VFA和SVER患者（与SV患者相比）以及男性（与女性相比）更有可能获得“优秀”结果：分别为3.4倍、3.3倍和3.6倍。
