Vocal fold augmentation by injection of autologous fascia.

Abstract

Vocal fold augmentation by injection under direct visual control is a quick and simple operation. However, when autologous fat or bovine collagen is used, resorption creates a problem. The low metabolic requirements and the relatively stable histologic character of free fascial grafts make autologous fascia a fascinating material in vocal fold augmentation. This research project was carried out to establish a suitable method to transplant fascia into a vocal fold and to assess its impact on the voice. A piece of fascia lata was chopped with a scalpel. The material was injected in the lateral aspect of the thyroarytenoid muscle using a pressure syringe. Nine subjects with a paralyzed vocal fold were analyzed after the injection. The postoperative voice, rated by a panel of experienced listeners, was significantly better than the preoperative (P < 0.05). Five of nine voices were rated normal or near normal after the procedure. The mean maximal phonation time increased significantly (P < 0.01). All patients considered that their voice had improved, and eight of nine regarded it as good. No one reported deterioration of the result during the follow-up (mean duration, 10 months; range, 3 to 18 months).