Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania 19103, USA.
J Voice. 2013 Jul;27(4):512-5. doi: 10.1016/j.jvoice.2013.03.009. Epub 2013 May 15.
To determine the efficacy of lipotransfer for treatment of various vocal fold (VF) pathologies.
Retrospective review.
We reviewed retrospectively the indications for and techniques of laryngeal lipotransfer and its effect on glottic closure and mucosal wave. One hundred four patients treated with lipotransfer between 1997 and 2010 were screened for inclusion in this study. Fifteen patients were excluded. Strobovideolaryngoscopic examinations for the 89 included subjects were reviewed to determine the change in glottic closure and mucosal wave. The degree of improvement, if any, was graded as mild, moderate, or substantial. The population was divided into the following four groups for analysis: (1) single lateral lipoinjection, (2) combination of lipoinjection and thyroplasty, (3) multiple lipoinjections with or without other injection medialization procedures, and (4) lipoimplantation for treatment of VF scar.
Lipotransfer was used alone and as an adjunct procedure to treat glottic insufficiency (GI) secondary to VF motion abnormality or vibratory margin pathology. Augmentation was accomplished either by lateral injection or by medial implantation through an access tunnel. Most patients showed a statistically significant improvement in glottic closure because of lipoinjection and in mucosal wave because of lipoimplantation. Few minor and no serious complications occurred.
Laryngeal lipotransfer is safe and effective for treatment of GI and VF scar.
评估脂肪移植在治疗各种声带(VF)病变中的疗效。
回顾性研究。
我们回顾性地审查了喉脂肪移植的适应证和技术,以及其对声门闭合和黏膜波的影响。筛选了 1997 年至 2010 年间接受脂肪移植治疗的 104 例患者,以纳入本研究。排除了 15 例患者。对 89 例纳入研究的患者进行频闪喉镜检查,以确定声门闭合和黏膜波的变化。如果有任何改善,其程度被分为轻度、中度或显著。将人群分为以下四组进行分析:(1)单侧脂肪注射,(2)脂肪注射联合甲状软骨成形术,(3)多部位脂肪注射联合或不联合其他注射内侧化手术,(4)脂肪植入治疗 VF 瘢痕。
脂肪移植单独或作为辅助手术用于治疗因 VF 运动异常或振动缘病变导致的声门闭合不全(GI)。通过侧向注射或通过进入隧道进行内侧植入来进行增强。大多数患者的声门闭合因脂肪注射而显著改善,黏膜波因脂肪植入而显著改善。仅出现少数轻微并发症,无严重并发症。
喉脂肪移植治疗 GI 和 VF 瘢痕安全有效。