Autologous Adipose Tissue Injection of Vocal Cords in Presbyphonia

Otolaryngol Head Neck Surg. 2022 Jul;167(1):118-124. doi: 10.1177/01945998211045292. Epub 2021 Sep 21.


Objective: This series evaluates the long-term results of autologous adipose injection (AAI) in patients older than 65 years with presbyphonia.

Study design: Retrospective cohort study.

Setting: Academic secondary medical center.

Methods: This was a retrospective study with a minimum follow-up of 12 months. All patients underwent AAI for atrophy of both vocal folds due to presbyphonia. We measured subjective parameters as Voice Handicap Index-10 (VHI-10) or GRBAS scale (grade, roughness, breathiness, asthenia, strain) and objective measures such as maximum phonation time (MPT) or square pixel closure defect. We reviewed the medical records of patients undergoing AAI during the 2011-2018 period. An analysis of the demographic variables of the group was performed, as well as the values of VHI-10, GRBAS, and MPT, and the minimum closure defect measured in square pixels and the number of closed frames in the glottal cycle before and after the intervention.

Results: At 12 months, 17 of 18 patients reported subjective and VHI-10 improvement. The mean preoperative VHI-10 (26.7) was significantly higher than the postoperative value (14.4), and the GRBAS scale had a preoperative mean of 8.7 and a postoperative mean of 4.3, both with statistical significance. MPT increased from 7.7 to 12.4 seconds (P < .0001). The minimum closure defect measurements obtained in square pixels changed from 305 to 124, achieving complete closure in 3 patients. The closed phase of the glottal cycle change from 14.3% to 38.2% after the AAI.

Conclusions: AAI improves long-term vocal fold closure, demonstrating utility in patients with presbyphonia.

Keywords: autologous fat; glottic insufficiency; presbyphonia; vocal fold atrophy; vocal fold injection.

Publication types

  • Review

MeSH terms

  • Adipose Tissue
  • Humans
  • Retrospective Studies
  • Treatment Outcome
  • Vocal Cords* / surgery
  • Voice Quality*