Microfractured Fat Injection Restores Voice in Paralyzed Vocal Cords
A. M. Saibene, C. Pipolo, R. Lorusso, S. M. Portaleone, G. Felisati · B-ENT · 2015
New outpatient procedure treats voice problems without general anesthesia
This small study explored a new approach for treating vocal cord paralysis. Researchers tested whether specially processed fat from a patient's own body could restore voice function. The procedure was done entirely through the nose while patients were awake. Three people with vocal cord paralysis received this treatment and were followed for at least 12 months.
Three patients with different causes saw voice improvement
The study included three adults whose vocal cord paralysis had different origins:
A 63-year-old woman with paralysis after tumor removal surgery
A 72-year-old man with paralysis following lung cancer surgery
A 65-year-old woman with paralysis after thyroid removal
All three experienced hoarseness. Two also had difficulty swallowing liquids safely. Their vocal cords could not close properly during speech, causing weak, breathy voices.
Fat tissue processed with Lipogems® flows easily through tiny needles
The researchers used Lipogems® technology to prepare the fat tissue. This device gently breaks down fat into smaller clusters while washing away blood and debris. The result is a smooth, fluid mixture that contains regenerative cells called mesenchymal stem cells (cells that support healing).
This processed fat has important advantages. It flows easily through small needles. This eliminated the need for special injection guns used in older techniques. The fat also contains about 80 percent pure fat tissue, which helps it stay in place longer with less absorption over time.
Procedure performed awake in about 30 minutes
The treatment involved two steps. First, doctors collected a small amount of fat from each patient's abdomen using standard liposuction under local numbing. Then they processed it through the Lipogems® device.
For the injection, patients received mild sedation and numbing spray in the nose and throat. Doctors used a flexible camera inserted through the nose to see the vocal cords directly. They injected the fat mixture through the camera's working channel using a thin needle. The fat was placed into the paralyzed vocal cord to push it toward the middle. This helps it meet the healthy cord during speech.
Patients went home the same day after about 30 minutes of monitoring.
Voice measures improved and held steady for 12 months
Doctors measured voice quality in several ways before and after treatment. Maximum phonation time measures how long someone can hold a sound on one breath. All three patients nearly doubled their time:
Patient one: six seconds before, 13 seconds at 12 months
Patient two: five seconds before, 12 seconds at 12 months
Patient three: seven seconds before, 13 seconds at 12 months
The Voice Handicap Index asks patients to rate how much voice problems affect daily life. Scores dropped substantially in all three cases, meaning voice problems interfered less. Professional voice ratings also improved across measures of breathiness, roughness, and strain.
No complications observed during the study period
All three patients tolerated the procedure well. Researchers reported no bleeding, breathing problems, or other complications. The improvements remained stable throughout the full 12-month follow-up period. The authors suggest this lasting benefit may relate to the regenerative stem cells present in the processed fat.
What this means for patients considering treatment
This study provides early evidence that Lipogems®-processed fat injection may help restore voice in vocal cord paralysis. The main advantages include:
Uses your own tissue, avoiding rejection risks
Performed awake as an outpatient
No special injection equipment needed
Improvements lasted at least one year
However, this was a very small study with only three patients and no comparison group. Larger studies with more patients are needed to confirm these findings. If you have vocal cord paralysis, discuss all treatment options with your doctor to determine what might work best for your situation.
---
Source: Saibene et al., B-ENT, 2015.
Original Publication
Transnasal endoscopic microfractured fat injection in glottic insufficiency
A. M. Saibene, C. Pipolo, R. Lorusso, S. M. Portaleone, G. Felisati · B-ENT · 2015
This study evaluated a novel treatment for glottic insufficiency involving transnasal endoscopic injection of autologous microfractured fat. Three patients with vocal cord palsy underwent laryngoplasty under local anaesthesia using a flexible endoscope with a working canal for Microfractured Fat Fibre-endoscopic Injection (MFFI). Adipose tissue was processed using the Lipogems® device, which produces an emulsion with optimal purity, fluidity, and mesenchymal stem cell content. The device employs metal marbles to microfracture fat tissue while a saline-irrigated filtering system refines the aspirate, resulting in 80% fat content with minimal blood and connective tissue residue. The fluid consistency allows use of smaller needles without requiring an injection pistol. Under local anesthesia and mild sedation, fat was injected laterally into the vocal process of the affected fold through the endoscope's working channel, with direct visualization of the glottis. MFFI was well tolerated with no complications observed. During the 12-month follow-up period, voice improvement was constant in all three patients, assessed by maximum phonation time, Voice Handicap Index scores, and GRBAS values. Results suggest stem cell-related regenerative potential of the procedure. MFFI represents an efficacious outpatient treatment combining advantages of existing treatments while using only autologous material with direct endoscopic visualization.