Augmentation of Vocal Fold Using a Fat Block Implant Following Cordotomy Through a Minithyrotomy Approach in a Rabbit Model

Objectives Minithyrotomy is a novel approach that provides direct access to the lamina propria and vocalis muscle without requiring incision of the vocal fold mucosa. The aim of this study was to demonstrate the efficacy of minithyrotomy vocal fold augmentation in a rabbit model by comparing the vocal fold total square amount and the density of scars between the cordotomy with minithyrotomy group and a cordotomy without minithyrotomy group. Study Design Animal study. Methods Twenty adult laboratory-conditioned female rabbits were used for this study. Minithyrotomy vocal fold augmentation was performed using a single fat block implant 3 months after cordotomy. To compare total square amount and density of vocal folds between the minithyrotomy and cordotomy group, hematoxylin and eosin, Masson’s trichrome, and alcian blue staining was used. Results Histological examinations showed that minithyrotomy vocal fold augmentation postoperatively restored vocal fold bulkiness and maintained volume for up to 6 months, compared with the cordotomy group (Pآ <آ 0.05). In light of the surgical manipulation, the procedure also did not aggravate scarring of the cordectomized vocal fold. Conclusions Minithyrotomy vocal fold augmentation using an autologous fat block may soon be feasible in humans undergoing rehabilitation for postcordotomy dysphonia without causing additional damage to the vocal folds.