Treatment of velopharyngeal insufficiency by autologous fat injection

Eur Arch Otorhinolaryngol. 2010 Jun;267(6):977-83. doi: 10.1007/s00405-009-1157-7. Epub 2009 Dec 23.


Velopharyngeal insufficiency (VPI) is a structural or functional trouble, which causes hypernasal speech. Velopharyngeal flaps, speech therapy and augmentation pharyngoplasty, using different implants, have all been used to address this trouble. We hereby present our results following rhinopharyngeal autologous fat injection in 18 patients with mild velopharyngeal insufficiency (12 soft palate clefts, 4 functional VPI, 2 myopathy). 28 injections were carried out between 2004 and 2007. The degree of hypernasal speech was evaluated pre- and postoperatively by a speech therapist and an ENT specialist and quantified by an acoustic nasometry (Kay Elemetrics). All patients were exhaustively treated with preoperative speech therapy (average, 8 years). The mean value of the nasalance score was 37% preoperatively and 23% postoperatively (p = 0.015). The hypernasality was reduced postoperatively in all patients (1-3 degrees of the Borel-Maisonny score). There were no major complications, two minor complications (one hematoma, one cervical pain). The autologous fat injection is a simple, safe, minimally invasive procedure. It proves to be efficient in cases of mild velopharyngeal insufficiency or after a suboptimal velopharyngoplasty.

MeSH terms

  • Adipose Tissue / transplantation*
  • Adolescent
  • Adult
  • Child
  • Cleft Palate / surgery
  • DiGeorge Syndrome / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Phonation / physiology
  • Postoperative Complications / etiology
  • Sound Spectrography
  • Speech Intelligibility
  • Velopharyngeal Insufficiency / etiology
  • Velopharyngeal Insufficiency / surgery*
  • Voice Disorders / etiology
  • Voice Disorders / surgery
  • Voice Quality / physiology
  • Young Adult