Nanofat for Injection Laryngoplasty: A Preliminary Study of a New Substrate.

OBJECTIVE

"Nanofat" refers to fat further emulsified into 1-µm sizes. It is commonly used in facial plastic surgery. Nanofat increases the release of adipose-derived stem cells. This study tested whether injection laryngoplasty using nanofat resulted in bulking and vibratory effects comparable to using microfat in treating patients with fold atrophy.

METHODS

This was a randomized, controlled, single-blind, prospective study of 18 patients with vocal atrophy who underwent transoral lipoinjection using microlaryngoscopy. The control group received bilateral microfat injection. The experimental group randomly received microfat in one vocal fold and nanofat in the contralateral vocal fold. The average volume of fat injected was 0.6 mL on each side. The postsurgery evaluation at 3 months included ratings of stroboscopy and acoustic recordings by blinded expert raters. Vibratory behavior, voice ratings, preVoice Handicap Index-10 (VHI-10) and postVHI-10 score, and Cepstral/Spectral Index of Dysphonia (CSID) were compared.

RESULTS

Significant improvement in the VHI at three-month follow-up was noted in all patients (n = 18 total, 12 experimental, six control). In the subgroup analysis, only the nanofat group significantly improved VHI. Improvements in the CSID were observed in both techniques; however, neither group showed statistical significance. Improved glottic closure was comparable in both groups. Expert raters observed an improvement in the voice quality of nanofat individuals but no change in microfat individuals.

CONCLUSION

Lipoinjection laryngoplasty with nanofat may be an alternative to microfat in patients with vocal atrophy.

LEVEL OF EVIDENCE: II.