B J Rodgers1, F W Abdul-Karim, M Strauss. 1. Department of Otolaryngology--Head and Neck Surgery, University Hospitals of Cleveland, Ohio 44106, USA.
Abstract
OBJECTIVE: Several methods have been used for the treatment of the unilateral paralyzed vocal fold. Teflon injections have been used extensively but not without complications. The ideal substance for injection is yet to be determined. Injected autologous fascia has been reported as a means of achieving glottic closure. In review of the literature, there are no long-term results described using autologous fascia in this way. The purpose of this study was to examine the histological changes of the larynx after injection of autologous fascia into a paralyzed vocal fold. STUDY DESIGN: A prospective study with the contralateral side of the larynx used as the control. METHODS: Six adult dogs underwent severing of one of their recurrent laryngeal nerves. After the vocal folds were confirmed to be paralyzed by direct laryngoscopy, fascia lata that was harvested from the animal was minced and injected into the paralyzed vocal fold. The dogs were then killed at intervals ranging from 3 to 12 months and their larynges reviewed histologically. RESULTS: The larynges revealed muscle atrophy of the vocal fold, which is consistent with denervation, but there was no evidence of persistent fascia. In addition, there was no evidence of reaction to the injected fascia. Special stains for collagen were also performed which showed no significant change from the non-injected vocal fold. CONCLUSION: From this model, it is concluded that injected autologous minced fascia is not a good short- or long-term substance for vocal fold augmentation. Further study is warranted to confirm this observation.
OBJECTIVE: Several methods have been used for the treatment of the unilateral paralyzed vocal fold. Teflon injections have been used extensively but not without complications. The ideal substance for injection is yet to be determined. Injected autologous fascia has been reported as a means of achieving glottic closure. In review of the literature, there are no long-term results described using autologous fascia in this way. The purpose of this study was to examine the histological changes of the larynx after injection of autologous fascia into a paralyzed vocal fold. STUDY DESIGN: A prospective study with the contralateral side of the larynx used as the control. METHODS: Six adult dogs underwent severing of one of their recurrent laryngeal nerves. After the vocal folds were confirmed to be paralyzed by direct laryngoscopy, fascia lata that was harvested from the animal was minced and injected into the paralyzed vocal fold. The dogs were then killed at intervals ranging from 3 to 12 months and their larynges reviewed histologically. RESULTS: The larynges revealed muscle atrophy of the vocal fold, which is consistent with denervation, but there was no evidence of persistent fascia. In addition, there was no evidence of reaction to the injected fascia. Special stains for collagen were also performed which showed no significant change from the non-injected vocal fold. CONCLUSION: From this model, it is concluded that injected autologous minced fascia is not a good short- or long-term substance for vocal fold augmentation. Further study is warranted to confirm this observation.
Authors: Bruno de Rezende Pinna; João Norberto Stavale; Paulo Augusto de Lima Pontes; Osíris de Oliveira Camponês do Brasil Journal: Braz J Otorhinolaryngol Date: 2011 Mar-Apr