Abstract
Patients with scarred vocal folds (congenitally or following phonosurgery) are currently difficult to treat and present a dysphonia, often disabling in daily life. Several therapies are available on the market but the results of these are often disappointing. The autologous adipose-derived stromal vascular fraction (ADSVF) is recognized as an easily accessible source of cells with angiogenic, anti-inflammatory, immunomodulatory, and regenerative properties. We present here the case of a 43-year-old woman who had a severe dysphonia associated with scarred vocal folds after a phonosurgery and was resistant to conventional medical and surgical treatments. She received a local administration of autologous ADSVF. The protocol involved, on the same day, adipose tissue extraction, ADSVF preparation, and then local injection (0.45ml of ADSVF in each vocal fold, for a total of 12.2 million ADSVF viable cells). No serious adverse events have been described. One year following the surgery, the laryngoscopic aspect and the majority of voice parameters had improved, in particular the Voice Handicap Index decreasing from 75 to 9. The perceptual analysis found the voice to be less hoarse and more stable, without breathiness. The case of this patient highlights the therapeutic potential of ADSVF for such applications (trial registration, ClinicalTrials.gov NCT02622464; registered 4 December 2015).
Highlights
Vocal fold (VF) microstructure [1, 2] is complex, due to its foliated organization
VF scarring is sometimes observed, due to partial disappearance of the lamina propria, with the superficial and/or intermediate layer replaced by fibrous tissue, preventing mechanical uncoupling of the epithelium and muscle and thereby inducing vibration disorder [1]
Patient A 43 year-old woman was included in the prospective phase I clinical trial CELLCORDES (EudraCT number 2015–000238-31) registered at clinicaltrials.gov, after providing written informed consent. Her medical history included a thyroidectomy for goiter and hysterectomy for endometriosis. She presented a severe dysphonia related to scarred VF following a phonosurgery
Summary
Vocal fold (VF) microstructure [1, 2] is complex, due to its foliated organization. The proportion and organization of the extracellular matrix components determine the mechanical properties of the VF. VF scarring is sometimes observed, due to partial disappearance of the lamina propria, with the superficial and/or intermediate layer replaced by fibrous tissue, preventing mechanical uncoupling of the epithelium and muscle and thereby inducing vibration disorder [1]. Scar tissue may be found congenitally, without iatrogenic etiology (e.g., sulcus vocalis). Several therapies are currently available but these are often disappointing as the great complexity of VF microstructure hinders the development of effective therapy. Identification of innovative strategies able to improve vibrational mechanical properties of VF remains an important clinical challenge
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
