Tsou Yung-An, Tien Vincent Hui-Chi, Chen Sheng-Hwa, Shih Liang-Chun, Lin Tzu-Chieh, Chiu Chien-Jen, Chang Wen-Dien
Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung 40402, Taiwan.
School of Medicine, China Medical University, Taichung 40402, Taiwan.
J Clin Med. 2022 Jan 29;11(3):725. doi: 10.3390/jcm11030725.
Sulcus vocalis is a frequent cause of glottic insufficiency that leads to incomplete vocal fold closure during phonation. Type II sulcus vocalis is defined as a partial defect of the lamina propria (LP). Treatment with fillers, such as fat or hyaluronic acid (HA), in the vocal folds is widely used, but the duration of effect is variable. Platelet-rich plasma (PRP) can enhance the survival of autologous fat in fat grafting, and also is used to treat sulcus vocalis. This study aimed to compare the effectiveness of autologous fat graft versus fat graft plus PRP to treat type II sulcus vocalis. Thirty-four patients with a voice handicap index (VHI) ≥ 11 were randomized to two groups, which received LP injections of fat graft ( = 17) or fat graft plus PRP ( = 17). At 1 month and 6 months after injection, the VHI decreased significantly in both groups. The fat plus PRP group had better Jitter, Shimmer, and noise to harmonic ratio (NHR) in 1 month and 6 months after surgery. The fat plus PRP group resulted in lower VHI scores one month after surgery, and stroboscopy revealed sustained smaller gaps after six months. These results indicate that a combination of fat graft plus PRP is safe and effective for treating sulcus vocalis type II and associated vocal atrophy.
声带沟是声门闭合不全的常见原因，可导致发声时声带闭合不全。II型声带沟被定义为固有层（LP）的部分缺损。在声带中使用填充剂（如脂肪或透明质酸（HA））进行治疗被广泛应用，但效果持续时间不一。富血小板血浆（PRP）可提高自体脂肪在脂肪移植中的存活率，也用于治疗声带沟。本研究旨在比较自体脂肪移植与脂肪移植加PRP治疗II型声带沟的效果。34名声带障碍指数（VHI）≥11的患者被随机分为两组，分别接受LP注射脂肪移植（n = 17）或脂肪移植加PRP（n = 17）。注射后1个月和6个月时，两组的VHI均显著下降。脂肪加PRP组在术后1个月和6个月时的抖动、闪烁及噪声谐波比（NHR）更好。脂肪加PRP组术后1个月时VHI评分更低，频闪喉镜检查显示6个月后间隙持续更小。这些结果表明，脂肪移植加PRP联合治疗II型声带沟及相关声带萎缩是安全有效的。
