Fat Versus Hyaluronic Acid Injection Laryngoplasty for Unilateral Vocal Fold Paralysis: Efficacy and Results

Abstract

Objectives: To compare the use of autologous fat versus hyaluronic acid in injection laryngoplasty for unilateral vocal fold paralysis. The efficacy of the materials regarding voice outcomes (voice handicap index, computerized speech lab) and duration will be statistically analyzed. Patients and Methods: A prospective study conducted on 38 randomly selected patients with unilateral vocal fold paralysis presented to ORL outpatient clinic at faculty of medicine – Cairo University randomized to receive either hyaluronic acid (HA) perfecta deep ® group A and autologus fat for group B. Postoperative evaluations were made based on Auditory Perceptual Assessment of Voice (APA), Computerized Speech Lab (CSL), jitter, shimmer, noise to harmonic ratio, patient satisfaction, phonatory gap and the need for another injection. Results: One month postoperatively, both groups showed significant improvement in CSL, APA and phonatory gap while six months postoperatively there was significant improvement in favor of group B. No serious adverse events were observed. 18 patients had been re-injected in group A while only 5 had been re-injected in group B due to insufficient voice. Conclusion: No side-effects were found for either hyaluronic acid or fat groups after injection. Both treatments after one month resulted in significantly improved voice as rated by the patients and significantly improved glottal closure. Resorption was noted for both substances, but mainly for hyaluronic acid/treatment.