Combined Modality Treatment of Sulcus Vocalis with AutologousFat Injection and Slicing Technique

Ahn, Cheol Min; Kim, Yong Woo

Abstract

BACKGROUND AND OBJECTIVES: Incomplete glottic closure of sulcus vocalis is one of the most common causes of breathy dysphonia. The results of treatment for sulcus vocalis were not satisfactory even though a variety of methods of treatment were applied because of incomplete glottic closure and improper mucosal waves of vocal fold on phonation. Authors studied to evaluate the efficacy of the combined modality treatment with autologous fat injection and slicing technique in patients with sulcus vocalis.
MATERIALS AND METHODS
Patients with sulcus vocalis complaining of breathy dysphonia and difficult phonation were diagnosed through detailed history using questionnaires, physical examination and stroboscopy. Autologous fat taken from the lower abdomen was injected for medialization of the bowed vocal fold under general anesthesia. After that, the dissected mucosa of the vocal fold was sliced. Follow-up studies were performed with patients' own subjective evaluations, perceptual analysis, stroboscopic findings and acoustic analysis.
RESULTS
Patients' own subjective evaluations, mucosal waves and glottic closure of vocal fold were much improved and perceptual and acoustic analysis were improved moderately in the follow-up results.
CONCLUSION
Patients could have better voice and easy phonation after surgery because more improved mucosal waves and glottic closure allowed vocal fold to vibrate more efficiently and allowed patients to accept the voice therapy comfortably. Combined modality treatment of autologous fat injection and slicing technique was therefore an effective method for patients with sulcus vocalis.