Gandhi Sachin, Gupta Shashank, Bhowmick Nilanjan, Pandurangi Aniketh, Desai Vrushali
Voice Clinic, Deenanath Mangeshkar Hospital, Superspeciality Building 1st Floor, Erandwane, Pune, 411004 India.
Indian J Otolaryngol Head Neck Surg. 2019 Mar;71(1):38-41. doi: 10.1007/s12070-018-1543-9. Epub 2018 Nov 30.
Neocord formation after Type III cordectomy is insufficient for complete glottic closure due to scarring and soft tissue deficit. This study evaluates the role of autologous fat injection (AFI) in phonosurgical management of patients who have previously undergone Type III cordectomy for early glottic cancer. Data was collected from hospital records of patients who underwent AFI after previously undergoing Type III cordectomy. A minimum duration of 6 months post-cordectomy was maintained before fat injection. Trans-oral injection was performed at a single site. Pre-operative voice evaluation was done using VHI, GRBAS scale and MDVP software. Post-operative evaluation was done at 6 weeks. 21 out of 62 post-Type III cordectomy patients chose to undergo fat augmentation and were included in the study. A comparison of pre-operative and 6 months post-operative AFI voice analysis showed a significant improvement in VHI, all parameters of GRBAS scale, and improvement in Jitter, Shimmer, SPI and NHR. There was a decrease in fundamental frequency but this was not statistically significant. AFI is an effective procedure for surgical voice rehabilitation of patients who have undergone Type III cordectomy for early laryngeal cancer.
III型声带切除术术后新声带形成因瘢痕形成和软组织缺损而不足以实现声门完全闭合。本研究评估自体脂肪注射(AFI)在先前因早期声门癌接受III型声带切除术患者的嗓音外科治疗中的作用。数据收集自先前接受III型声带切除术后接受AFI的患者的医院记录。在脂肪注射前,声带切除术后维持至少6个月的时间。经口在单个部位进行注射。术前嗓音评估使用嗓音障碍指数(VHI)、GRBAS量表和MDVP软件进行。术后评估在6周时进行。62例III型声带切除术后患者中有21例选择接受脂肪填充并纳入研究。术前和术后6个月AFI嗓音分析的比较显示,VHI、GRBAS量表的所有参数均有显著改善,基频微扰(Jitter)、振幅微扰(Shimmer)、谐噪比(SPI)和噪声谐波比(NHR)也有所改善。基频降低,但无统计学意义。AFI是对因早期喉癌接受III型声带切除术患者进行手术嗓音康复的有效方法。