Vocal cord augmentation with autogenous fat.

Since 1987, the authors have used a new technique for the augmentation and medialization of the paralyzed vocal cord. Eleven patients with paralyzed vocal cords and one patient with a surgical defect of the vocal cord have been treated with intracordal injections of autogenous fat harvested by suction from the abdominal wall. Treatment efficacy was evaluated by both subjective and objective (videostroboscopic) analyses. Patient follow-up has ranged from 5 to 42 months. All patients showed significant improvement in voice characteristics. Marked reduction in air flow and increased vocal intensity were observed. Correction of glottic insufficiency has been lasting, indicating that the implanted fat cells are viable. At this time, there has been no evidence of loss of vocal cord substance. The natural qualities of autogenous fat appear to make it an excellent alternative to Teflon or collagen. The fat is readily available, and easily harvested and injected. A larger patient population and longer follow-up periods will help determine if these initial findings are consistent.