Long‐Term Follow‐up of Fat Injection Laryngoplasty for Unilateral Vocal Cord Paralysis

McCulloch, Timothy M.; Andrews, Brian T.; Hoffman, Henry T.; Graham, Scott M.; Karnell, Michael P.; Minnick, Corey

doi:10.1097/00005537-200207000-00017

Cited by 118 publications

(111 citation statements)

References 16 publications

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“…Fang et al 14 followed 33 patients undergoing AAI for UVFP and found that 89% of patients were satisfied with results and the satisfactory result was maintained after 12 months of follow-up, concluding that AAI improves both voice and quality of life outcomes in treated patients. Conversely, McCulloch et al 15 performed a retrospective review to analyze outcomes of 31 patients who underwent fat injection laryngoplasty and determined success rates at 1 year and 4 years to be 70% and 55%. Thirteen patients (41%) required additional procedure or injection to achieve adequate vocal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Augmentation Autologous Adipose Injections in the Larynx

Benninger

Hanick

Nowacki

2015

Ann Otol Rhinol Laryngol

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Objective: Autologous adipose injection (AAI) is a recognized method for vocal fold augmentation. The study's purpose is to explore short-and long-term outcomes of AAI. Methods: Retrospective chart review of 43 patients undergoing AAI was performed; patient perception of outcome, Voice Handicap Index (VHI), maximum phonatory time (MPT), and disposition were evaluated. Results: Over 5 years, 43 AAI patients had documented postoperative follow-up (25 paralysis, 8 paresis, 9 bowing/presbylarynges, and 5 scar/sulci). Mean follow-up was 32 weeks. There was gradual patient loss to follow-up. Thirty-nine of 40 (98%) had patientreported improvement at 6 weeks, 28 of 34 (82%) had improvement at 2 to 6 months, with 10 of 12 (83%) sustaining their improvement for >1 year. Significant improvement in mean VHI was observed at 4 to 6 weeks (mean reduction, 26; P < .0001) and 2 to 6 months (mean reduction, 23; P < .0001). Improvement in mean MPT was observed at 4 to 6 weeks (mean increase, 8 s; P < .0001), 2 to 6 months (6 s; P = .007), and >1 year (4 s; P = .03). Eight patients went on to medialization laryngoplasty. Conclusion: AAI successfully augments vocal folds in short-term outcomes with some gradual decrease in effectiveness. Although patient attrition limited conclusions, objective long-term benefit may occur in >50% of patients.

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Section: Discussionmentioning

confidence: 99%

Augmentation Autologous Adipose Injections in the Larynx

Benninger

Hanick

Nowacki

2015

Ann Otol Rhinol Laryngol

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“…In cases with RLN involvement via metastatic nodes, the RLN is sometimes resected together with metastatic nodes to enable a curative operation (Tachimori et al 1995). Laryngeal reinnervation should be considered in such cases, since this procedure can prevent the progressive loss of thyroarytenoid muscle tone and stiffness, which cannot be restored reliably using other techniques (Lu et al 1996;McCulloch et al 2002).…”

Section: Introductionmentioning

confidence: 99%

Recurrent Laryngeal Nerve Paralysis after Esophagectomy: Respiratory Complications and Role of Nerve Reconstruction

Koyanagi

Igaki

Iwabu

et al. 2015

Tohoku J. Exp. Med.

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Recurrent laryngeal nerve paralysis (RLNP) after esophagectomy is a common complication and associated with aspiration pneumonia. In this study, we assessed the risk of RLNP and the usefulness of immediate reconstruction of recurrent laryngeal nerve (RLN) to prevent respiratory complications after esophagectomy. Seven hundred and eighty-two consecutive patients underwent an esophagectomy with three-field lymph node dissection, simultaneous gastric conduit reconstruction, and cervical anastomosis. Vocal cord function was observed using a flexible laryngoscope. Reconstruction between RLN and ipsilateral vagus nerve was performed during esophagectomy. RLNP was observed in 229 (29.3%) of the patients after esophagectomy: 198 unilateral and 31 bilateral cases. Of the 198 unilateral RLNP, vocal cord paralysis was observed predominantly on the left side (82.7%). RLNP was significantly associated with postoperative respiratory complications (P < 0.001) requiring a tracheotomy (P < 0.001) and mechanical ventilation (P < 0.001) and was also associated with esophagogastric anastomotic leakage (P = 0.015); consequently, the postoperative hospital stay was longer for patients with RLNP (P < 0.001). A longer operation time (P < 0.001) and advanced age (P = 0.038) were identified as significant independent predictors of RLNP. Resection of the RLN together with metastatic nodes was performed in 29 cases. The patients underwent RLN reconstruction (n = 11) had a significantly shorter postoperative hospital stay than those without RLN reconstruction (n = 18) (P = 0.019). In conclusion, RLNP was related to a poorer postoperative course among patients undergoing an esophagectomy. New surgical technologies are recommended for prevention of RLNP.

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“…These stem cells have a high proliferative potential and the ability to differentiate down multiple lineages (Lo Cicero et al, 2008). These data suggest that a resident MSC population in vocal fold fat injections may contribute to long-term graft survival, which is suspected to occur in 55-100% of patients (McCulloch et al, 2002;Lo Cicero et al, 2008). Commercially available composite materials have also been commonly used in clinic, such as Gelfoam paste (Schramm et al, 1978), Cymetra (Milstein et al, 2005), calcium hydroxylapatite (Rosen et al, 2007), Restylane and Hylaform (Hertegard et al, 2006b).…”

Section: Scaffolds Without Cellsmentioning

confidence: 87%

“…Synthetic materials (silicone, polytetrafluoroethylene-Teflon, polyhydroxyethylmethacrylate) have largely been eschewed for clinical use because of their propensity for foreign body response, migration of material and non-biodegradability (Ejnell et al, 1984;Nakayama et al, 1993). These materials have been replaced in the clinic by more degradable biomaterials, such as collagen matrix (Kriesel et al, 2002) and fat (McCulloch et al, 2002;Lo Cicero et al, 2008). These materials have viscoelastic properties more similar to vocal mucosa than the previous injectables.…”

Section: Scaffolds Without Cellsmentioning

confidence: 99%