Office-based Autologous Fat Injection Laryngoplasty for Vocal Process Granuloma

Objective. To present the outcomes of office-based autologous fat injection laryngoplasty for the treatment of vocal process granuloma in conjunction with glottic insufficiency. Study Design. Retrospective chart review. Methods. This study included nine patients with vocal process granuloma in conjunction with glottic insufficiency who received autologous fat injection laryngoplasty. Videolaryngostroboscopic data, objective voice assessment, perceptual measurements of vocal quality, and subjective ratings of voice quality were examined before and after treatment. Results. Of the nine patients, seven (78%) exhibited complete remission. The other two patients (22%) exhibited a partial response following the injection. In a subgroup of five patients who were refractory to antireflux and voice therapies, the resolution rate was 60%. Phonatory function presented significant improvements in jitter,noise-to-harmonic ratio, maximal phonation time, and asthenia. Videolaryngostroboscopic rating revealed significant improvements in closure phase ratio in the vibratory cycle. Conclusions. Autologous fat injection laryngoplasty can ameliorate glottic insufficiency and the resulting hyper-functional behavior of the larynx. This therapy also encourages remission of vocal process granuloma and may represent an alternative treatment strategy.