AUTOLOGOUS COLLAGEN VOCAL FOLD INJECTION - A PRELIMINARY CLINICAL-STUDY

This preliminary study reports the first use of injectable autologous collagen for vocal fold augmentation. In previous studies, the authors showed crosslinked bovine collagen to be effective in more than 150 p atients with glottic incompetence, particularly those with focal defec ts or scarred or atrophic vocal folds. However, concerns about possibl e adverse immunologic responses to the bovine material have limited it s use. The authors studied eight patients with difficult vocal fold pa thology, including sulcus vocalis, atrophy, and scarring secondary to trauma and cordectomy. Skin was harvested under local anesthesia, proc essed into a naturally cross-linked injectable form (Autologen(R)), an d injected using indirect laryngoscopy. Voice production was evaluated prior to the injection and at intervals after the injection, using su bjective, perceptual, aerodynamic, acoustic, and videostroboscopic ass essments. The results indicate that autologous collagen is comparable to injectable bovine collagen in the management of several difficult g lottic insufficiency problems and that the likelihood of a hypersensit ivity response is negligible. Unlike bovine collagen preparations, Aut ologen does not require breakdown of the natural collagen molecule, so it is anticipated that this material will be better tolerated and mor e stable over time.