Open Access
CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S176
DOI: 10.1055/s-0042-1746441
Poster
Aerodigestive tract / Laryngology: Larynx

Vocal fold augmentation with autologous fat using a 3D-Exoscope

Authors

  • Hans Nikolaus Caspar Eckel

    1   Klinik und Poliklinik für Hals-, Nasen-, und Ohrenheilkunde, Universitätsklinik Köln, Köln

  • Kevin Hansen

    1   Klinik und Poliklinik für Hals-, Nasen-, und Ohrenheilkunde, Universitätsklinik Köln, Köln

  • Antonia Nolte

    1   Klinik und Poliklinik für Hals-, Nasen-, und Ohrenheilkunde, Universitätsklinik Köln, Köln

  • Ruth Lang-Roth

    1   Klinik und Poliklinik für Hals-, Nasen-, und Ohrenheilkunde, Universitätsklinik Köln, Köln

  • Jens Peter Klußmann

    1   Klinik und Poliklinik für Hals-, Nasen-, und Ohrenheilkunde, Universitätsklinik Köln, Köln
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Introduction Vocal fold augmentation using autologous fat was demonstrated to be an effective solution for unilateral vocal fold paralysis. Developments such as liposuction and centrifugation have contributed to improving results. Since 2019 we apply a 3D-Exoscope system in laryngeal microsurgery, aiming to further advance this procedure.

Aim To compare the results of vocal fold augmentation using operating microscope to procedures performed using a 3D-Exoskope in 15 patients. The injection was performed via direct microlaryngoscopy using a 3D-Exoscope (VITOM© Karl Storz). Voice quality was measured pre intervention and six months after injection augmentation using Voice Handicap Index (VHI-30), maximum phonation time (MPT) and RBH (roughness, breathiness, hoarseness) perceptual evaluation.

Results Mean VHI-30 significantly decreased following the intervention (VHI pre: 67,26, post: 44,92; p < .001). A significant improvement of mean MPT (pre: 7,75s post: 11,5s; p < .001) was observed. Perceptual voice quality showed significant improvement in breathiness (pre: 1,94 post: 1,4; p < .001) and improvement of no significance in hoarseness (pre: 2 post: 1,8; p < .065). Vocal fold closure during phonation was improved in 13 patients despite a limited amount of fat resorption.

Conclusions Our results show that the use of a 3D-Exoscope in microlaryngoscopy is a promising alternative in vocal fold augmentation. The higher depth of field observable via the exoscope compared to an operating microscope allows for excellent judgement of injection depth. Also, the relatively small camera system allows for increased maneuverability. Results of vocal cord augmentation in our cases are comparable to results using a microscope, published elsewhere.



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Artikel online veröffentlicht:
24. Mai 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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