Lipoinjection Shown Safe and Effective at Least Six Months Post-Treatment for Unilateral Vocal Fold Paralysis

How predictable is lipoinjection as a treatment for unilateral vocal fold paralysis (UVFP)?

BOTTOM LINE

Lipoinjection seems to be a safe, therapeutic option for patients with UVFP, with efficacy lasting six months to one year.

BACKGROUND: Unilateral vocal fold paralysis is a potentially life-altering condition traditionally treated with speech therapy or surgical intervention. One surgical option is injection laryngoplasty, which can be performed using a variety of materials. Although it’s biocompatible and easily available, autologous fat used in injection laryngoplasty is considered unpredictable.

STUDY DESIGN: Systematic review and meta-analysis.

SETTING: Department of Otolaryngology–Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.

SYNOPSIS: Researchers conducted a systematic literature review for studies analyzing the data of patients diagnosed with UVFP who were treated with lipoinjection. They identified 49 articles representing 1,166 patients; 33 of the studies looked at data exclusively from patients treated with lipoinjection for UVFP. Injections were done under general or local anesthesia with a transoral injection through the laryngoscope, transcutaneous through the thyrohyoid or cricothyroid membrane, or transnasal through the working port of a flexible endoscope. No major complications were reported in any of these techniques. Two harvesting techniques were used: liposuction and traditional harvesting. The researchers’ subgroup analysis concluded in no statistically significant difference between them. At six months, almost all parameters used in the studies to assess outcome showed a significant voice improvement, and most patients rated their experience as excellent, very good, or good. A reintervention was required after 86 lipoinjections because of unsatisfactory or worsening results. The most reported complication was dysphonia or globus sensation. Study limitations included the differences among studies, designs, patients, and surgical techniques, and a lack of available long-term data.

CITATION: Haddad R, Ismail S, Khalaf MG, et al. Lipoinjection for unilateral vocal fold paralysis treatment: a systematic review and meta-analysis. Laryngoscope. 2022;132:1630–1640.