Autologous Fat Augmentation in Post Type III Cordectomy Patients

Abstract

Neocord formation after Type III cordectomy is insufficient for complete glottic closure due to scarring and soft tissue deficit. This study evaluates the role of autologous fat injection (AFI) in phonosurgical management of patients who have previously undergone Type III cordectomy for early glottic cancer. Data was collected from hospital records of patients who underwent AFI after previously undergoing Type III cordectomy. A minimum duration of 6 months post-cordectomy was maintained before fat injection. Trans-oral injection was performed at a single site. Pre-operative voice evaluation was done using VHI, GRBAS scale and MDVP software. Post-operative evaluation was done at 6 weeks. 21 out of 62 post-Type III cordectomy patients chose to undergo fat augmentation and were included in the study. A comparison of pre-operative and 6 months post-operative AFI voice analysis showed a significant improvement in VHI, all parameters of GRBAS scale, and improvement in Jitter, Shimmer, SPI and NHR. There was a decrease in fundamental frequency but this was not statistically significant. AFI is an effective procedure for surgical voice rehabilitation of patients who have undergone Type III cordectomy for early laryngeal cancer.

Primary injection laryngoplasty after chordectomy for small glottic carcinomas

“…Chordectomy types III or higher have been shown to be frequently associated with increased impairment of vocal function [ 4 ]. The main alternative to primary laryngoplasty immediately after tumor resection is secondary laryngoplasty or thyreoplasty after a time interval of 6–12 months [ 13 , 25 ]. One consequence of the secondary approach is that during this time interval many patients suffer from poor voice quality after chordectomy.…”

“…Besides, for voice rehabilitation other surgical techniques including laryngoplasties and thyreoplasties [12][13][14] have been established. For laryngoplasties which augment the vocal folds, many different synthetic or autologous fillers such as polytetrafluoroethylene (Teflon), calcium hydroxylapatite (CaHa), collagen, hyaluronic acid and fat have been used [15][16][17].…”