Laryngeal Lipotransfer: Review of a 14-Year Experience

Objective To determine the efficacy of lipotransfer for treatment of various vocal fold (VF) pathologies. Study Type Retrospective review. Methods We reviewed retrospectively the indications for and techniques of laryngeal lipotransfer and its effect on glottic closure and mucosal wave. One hundred four patients treated with lipotransfer between 1997 and 2010 were screened for inclusion in this study. Fifteen patients were excluded. Strobovideolaryngoscopic examinations for the 89 included subjects were reviewed to determine the change in glottic closure and mucosal wave. The degree of improvement, if any, was graded as mild, moderate, or substantial. The population was divided into the following four groups for analysis: (1) single lateral lipoinjection, (2) combination of lipoinjection and thyroplasty, (3) multiple lipoinjections with or without other injection medialization procedures, and (4) lipoimplantation for treatment of VF scar. Results Lipotransfer was used alone and as an adjunct procedure to treat glottic insufficiency (GI) secondary to VF motion abnormality or vibratory margin pathology. Augmentation was accomplished either by lateral injection or by medial implantation through an access tunnel. Most patients showed a statistically significant improvement in glottic closure because of lipoinjection and in mucosal wave because of lipoimplantation. Few minor and no serious complications occurred. Conclusion Laryngeal lipotransfer is safe and effective for treatment of GI and VF scar.