Evaluating the Role of Adding Platelet-Rich Plasma to Autologous Fat Injection for Unilateral Vocal Fold Immobility: A Comparative Study.

Abstract

Objectives: This study assessed the efficacy and safety of vocal fold injection using autologous fat combined with platelet-rich plasma (PRP) compared with autologous fat alone in patients with unilateral vocal fold immobility (UVFI).

Study design: A randomized controlled trial included 50 patients with dysphonia due to UVFI. Group A (25 patients) received an injection of autologous fat combined with PRP, while Group B (25 patients) received autologous fat only.

Methods: Patients were evaluated using the modified GRBAS scale, telescopic laryngeal examination, the Arabic version of the Voice Handicap Index (VHI), computerized speech lab (CSL), and maximum phonation time (MPT). Assessments were conducted preinjection and at 1 and 12 months postinjection.

Results: Group A showed significantly better outcomes in dysphonia grade, breathiness, and glottal gap at 1 month, but differences diminished by 12 months. Both groups improved similarly over time in jitter, shimmer, noise-to-harmonic ratio (NHR), MPT, and VHI, with no significant between-group differences. No postoperative complications were observed in either group, and none required reinjection 12 months after injection.

Conclusion: Injection laryngoplasty using a combination of autologous fat and PRP is a safe and effective method for managing UVFI. While early subjective voice improvement was noted at 1 month in the PRP group, these differences were not sustained at 12 months. Thus, the addition of PRP to fat injection may provide transient early benefits but does not demonstrate clinically significant long-term superiority. Further studies with extended follow-up and more advanced instrumental assessment tools are still recommended for better management of UVFI.