Fat Injection for Voice Improvement in Atrophic Vocal Folds

Abstract

With the incidence of geriatric dysphonia expected to rise in conjunction with the aging population in Japan, we propose a vocal fold injection augmentation technique with autologous fat for vocal improvement. Vocal fold injection augmentation is a safe, simple procedure that can improve quality of life (QOL) by enabling vocal improvement within a shorter period than voice training, without the need for open surgery. Between April 2012 and March 2016, we performed vocal fold injection augmentation with autologous fat under general anesthesia for 18 men and 3 women (mean age, 66 years; range, 60–79 years). Buccal fat tissue was used for the injection; therefore, no skin incisions were required. Evaluation following fat injection was based on maximum phonation time, auditory impression (GRBAS; G: grade of hoarseness, R: rough, B: breathy, A: asthenic, S: strained), and Voice Handicap Index-10 (VHI10) score. Auditory impression improved significantly and VHI10 score also tended to improve after injection. Vocal fold injection augmentation technique with autologous fat is minimally invasive, does not require the use of biologically foreign material, and appears effective for improving voice and QOL by enhancing the vocal folds of elderly individuals.