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Vocal Fold Lipoinjection

Contributor: VyVy N. Young and Clark A. Rosen

Lipoinjection of the vocal folds results in medialization and augmentation of the vocal folds by deposition of autologous fat.

Editor Recruited By: Michael Johns, III, MD

DOI: http://dx.doi.org/10.17797/ngjuxe20iq

Vocal fold injection
Vocal fold paralysis, vocal fold paresis, vocal fold atrophy, sulcus vocalis, severe vocal fold scar, soft tissue loss of the vocal fold(s)
Bilateral vocal fold immobility/hypomobility, coagulopathy (relative)
General anesthesia and endotracheal intubation; liposuction is performed after sterile prep and draping; microsuspension laryngoscopy can be performed as a clean procedure.
Check coagulation status if patient is anti-coagulated.
Make a 5mm abdominal incision in the right lower quadrant of the abdomen. Aim liposuction cannula opening upwards in the subcutaneous plane to prevent accidental penetration into deep abdominal contents.
Advantages: provides a large amount of autologous injectable material, less invasive compared to a medialization laryngoplasty, expedient. Disadvantages: 10-15% revision rate due to fat resorption.
Airway obstruction, infection and/or hematoma at the abdominal liposuction site, overinjection, underinjection, fat resorption requiring revision surgery.
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Rosen CA and Simpson CB (2008). Operative Techniques in Laryngology. Chapter 31. Vocal Fold Augmentation - via Direct Microlaryngoscopy. Pages 200-202. Springer, Berlin. Cantarella G, Mazzola RF, Domenichini E, Arnour F, Maraschi B (2005) Vocal fold augmentation by autologous fat injection with lipostructure procedure. Otolaryngol Head Neck Surg 132: 239-243. Hsiung MW, Lin YS, Su FW, Wang HW (2003) Autogenous fat injection for vocal fold atrophy. Eur Arch Otorhinolaryngol 260: 469-474. Laccourreye O et al (2003) Intracordal injection of autologous fat in patients with unilateral laryngeal nerve paralysis, long-term results from the patient's perspective. Laryngoscope 113: 541-545.

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