Primary injection laryngoplasty after chordectomy for small glottic carcinomas

Eur Arch Otorhinolaryngol. 2023 Mar;280(3):1291-1299. doi: 10.1007/s00405-022-07663-6. Epub 2022 Oct 5.

Abstract

Objectives: The purpose of this study was to analyze the short- and middle-term effects of primary injection laryngoplasty in patients having tumor resection within the same surgery concerning the vocal outcome. Injection laryngoplasty was performed after harvesting autologous adipose tissue via lipoaspiration.

Methods: A prospective study was performed with 16 patients (2 female; 14 male) who received tumor resection and an injection laryngoplasty using autologous adipose tissue during a single stage procedure. Multidimensional voice evaluation including videostroboscopy, patient self-assessment, voice perception, aerodynamics, and acoustic parameters was performed preoperatively, as well as 1.5, 3 and 6 months postoperatively.

Results: Results show an improvement in the roughness-breathiness-hoarseness (RBH) scale, voice dynamics and subjective voice perception 6 months postoperatively. Maintenance of Voice Handycap Index, jitter and shimmer could be observed 6 months postoperatively. There was no deterioration in RBH and subjective voice perception 2 and 6 weeks postoperatively. No complications occurred in the fat harvesting site.

Conclusions: Using the lipoaspiration and centrifugation approach, primary fat injection laryngoplasty shows short-term maintenance und middle-term improvement in voice quality in patients with vocal fold defect immediately after chordectomy 6 months postoperatively. Cancer recurrence rate is comparable to the reported cancer recurrence rate for laryngeal carcinoma and thus not elevated through primary augmentation.

Keywords: Adipose-derived stem cells; Autologous adipose tissue; Chordectomy; Glottic cancer; Injection laryngoplasty; Voice outcome.

MeSH terms

  • Carcinoma* / complications
  • Carcinoma* / surgery
  • Female
  • Hoarseness / etiology
  • Humans
  • Laryngeal Neoplasms* / complications
  • Laryngeal Neoplasms* / surgery
  • Laryngoplasty* / methods
  • Male
  • Neoplasm Recurrence, Local / surgery
  • Prospective Studies
  • Treatment Outcome
  • Vocal Cord Paralysis* / surgery