Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17. listopadu 1790, 70800, Ostrava, Czech Republic.
Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 70300, Ostrava, Czech Republic.
Eur Arch Otorhinolaryngol. 2021 Apr;278(4):1139-1144. doi: 10.1007/s00405-020-06479-6. Epub 2020 Nov 23.
To evaluate 5-year voice outcomes of vocal fold augmentation (VFA) using autologous fat (AF) injection via direct microlaryngoscopy versus office-based calcium hydroxylapatite (CaHA) injection.
Retrospective study of patients who underwent VFA between 2012 and 2015, with a 5-year follow-up. Patients with a glottic gap of ≤ 3 mm caused by unilateral vocal fold paralysis or vocal fold atrophy were included in the study. VFA was performed using AF injection via direct microlaryngoscopy in 17 patients, and using office-based CaHA injection in 19 patients. Subjective satisfaction with voice, voice handicap index (VHI), and maximal phonation time (MPT) were analyzed pre-injection, and at 12 and 60 months post-VFA.
Altogether 36 patients underwent VFA between 2012 and 2015, of whom 5 were excluded within 1 year post-VFA, and 2 were excluded between 1 and 5 years post-VFA. Of the remaining 29 patients, 3 (10.3%) underwent re-intervention at between 1 and 3 years post-VFA. Thus, the 5-year follow-up included 26 patients (72.2%; 11 males and 15 females). At 5 years after surgery, 73.1% of the patients were satisfied with their voice, with no significant between-group difference (P = 0.307). The mean improvement of VHI was 28.8 ± 17.82 in the autologous fat group versus 33 ± 26.24 in the CaHA group (P = 0.458). MPT improvement was also similar between the two groups: 6.2 ± 4.26 for the autologous fat group versus 6.3 ± 4.34 for the CaHA group (P = 0.667).
Both AF injection via direct microlaryngoscopy and office-based CaHA injection yielded good and comparable 5-year results.
通过直接显微镜喉镜评估自体脂肪（AF）注射与基于办公室的羟基磷灰石钙（CaHA）注射进行声带增强（VFA）的 5 年嗓音结果。
对 2012 年至 2015 年间接受 VFA 治疗且随访时间达到 5 年的患者进行回顾性研究。本研究纳入了因单侧声带麻痹或声带萎缩导致声门裂间隙≤3mm 的患者。17 例患者采用直接显微镜喉镜下 AF 注射进行 VFA，19 例患者采用基于办公室的 CaHA 注射进行 VFA。在注射前、注射后 12 个月和 60 个月分别分析患者的主观嗓音满意度、嗓音障碍指数（VHI）和最大发音时间（MPT）。
共有 36 例患者在 2012 年至 2015 年间接受了 VFA 治疗，其中 5 例患者在 VFA 后 1 年内被排除，2 例患者在 VFA 后 1 至 5 年内被排除。在其余 29 例患者中，有 3 例（10.3%）在 VFA 后 1 至 3 年内再次接受干预。因此，26 例患者（72.2%；11 名男性和 15 名女性）完成了 5 年随访。术后 5 年，73.1%的患者对自己的嗓音满意，两组间无显著差异（P=0.307）。自体脂肪组 VHI 的平均改善值为 28.8±17.82，而 CaHA 组为 33±26.24（P=0.458）。两组 MPT 的改善也相似：自体脂肪组为 6.2±4.26，CaHA 组为 6.3±4.34（P=0.667）。
通过直接显微镜喉镜进行 AF 注射和基于办公室的 CaHA 注射均可获得良好且相似的 5 年疗效。
