Shaw G Y, Szewczyk M A, Searle J, Woodroof J
Department of Otolaryngology, University of Kansas Medical Center, Kansas City 66160, USA.
Laryngoscope. 1997 Feb;107(2):177-86. doi: 10.1097/00005537-199702000-00008.
Numerous materials have been used over the years for vocal fold augmentation. Early use of bioreactive compounds, such as paraffin, gave way to relatively inert substances, such as Teflon. More recently biocompatible materials, such as collagen and autologous fat, have gained wider acceptance. Autologous fat, in particular, is an easily obtainable source for potential rehabilitation of scarred, paralytic, and atrophic vocal folds. However, long-term systematic follow-up has been lacking. Since 1991 we at the University of Kansas Center for Voice and Swallowing Disorders have employed autologous fat for vocal fold augmentation, primarily for either paralysis or repair of a volume-deficient vocal fold segment. Twenty-two patients have completed > or = 1 year of follow-up studies, including graded video-laryngostroboscopy, electroglottography, computerized acoustic analysis, and blinded perceptual analysis by two speech-language pathologists. Statistically significant improvement was demonstrated in many parameters tested, frequently improving with time. Although the volume-deficient group had more "normal" values, the paralysis group had greater improvement in many variables using fat injection. We conclude that while autologous fat injections of the vocal fold may have long-term benefits, certain technical considerations and criteria of selection of patients are critical for success.
多年来，人们使用了多种材料来进行声带增厚。早期使用的生物活性化合物，如石蜡，已被相对惰性的物质，如特氟龙所取代。最近，生物相容性材料，如胶原蛋白和自体脂肪，已获得更广泛的认可。特别是自体脂肪，是修复瘢痕性、麻痹性和萎缩性声带的潜在的易于获取的来源。然而，长期的系统随访一直缺乏。自1991年以来，我们堪萨斯大学嗓音与吞咽障碍中心一直使用自体脂肪进行声带增厚，主要用于治疗声带麻痹或修复声带容积不足的节段。22名患者完成了≥1年的随访研究，包括分级视频喉镜频闪检查、电声门图、计算机声学分析以及由两名言语病理学家进行的盲法感知分析。在许多测试参数中都显示出统计学上的显著改善，且常常随时间而改善。虽然声带容积不足组有更多“正常”值，但麻痹组在使用脂肪注射的许多变量中改善更大。我们得出结论，虽然声带自体脂肪注射可能有长期益处，但某些技术考虑因素和患者选择标准对成功至关重要。
