VOCAL CORD INJECTION WITH AUTOGENOUS FAT - A LONG-TERM MAGNETIC-RESONANCE-IMAGING EVALUATION

Since 1987, the senior author has injected autogenous fat into paralyz ed or atrophic vocal cords as an alternative to alloplastic substances for vocal cord augmentation and medialization. To determine the fate of the injected autogenous fat, the injected vocal cords of 10 patient s were evaluated by laryngeal magnetic resonance imaging (MRI) in the sagittal, coronal, and axial planes. Imaging studies were performed as early as 17 hours after surgery to as long as 31 months after fat inj ection. In 9 patients, identification of a fat signal within the previ ously injected vocal cords was observed (including the 31-month postop erative follow-up). In 1 patient, no fat signal was identified 13 mont hs after surgery, but the vocal cord was noted to have a bulging enlar ged contour. The results of this imaging study provide further evidenc e that autogenous fat, which has not been damaged during harvesting or microinjection, can survive transplantation into the vocal cord. The bulk of the vocal cord is maintained by microlipocytes and fibrous con nective tissue, both of which replace the damaged fat cells that are g radually being reabsorbed.