Fat augmentation following microsurgical removal of the vocal nodules

Objectives: Autogenous fat augmentation has been used as a treatment for glottic insufficiency. However, no information is available on the effectiveness of fat injection in patients with vocal nodules or recurrent vocal nodules after surgery. Study Design: The retrospective study reviews the efficiency of fat injection after surgery in patients with vocal nodules (n = 18) and recurrent vocal nodules (n = 5). Methods: The perceptual acoustic, phonatory function, and video laryngostroboscopic data were evaluated before and after surgery in 23 patients. Results: Mean follow-up time was 7.5 months. Nineteen patients had excellent results. Two patients had improvement, and no change was observed in two patients. Phonatory function showed significant improvement in shimmer, harmonic-to-noise ratio (P <.05), maximum phonation time, grade, roughness, and breathiness (P <.001). Video laryngostroboscopic rating showed significant improvement in linearity of the vocal fold edge, amplitude of vocal fold vibration, and excursion of the mucosal wave (P <.001). Less improvement was observed in recurrent vocal nodules than in nonrecurrent vocal nodules. Conclusions: Fat injection is an effective autogenous implant and may be considered as an option in management of patients with vocal nodules after surgery. Recurrence of nodules is a problem, but the procedure may be repeated.