Autologous transplantation of fascia into the vocal fold: Long-term results of a new phonosurgical technique for glottal incompetence

Objectives: To study the long-term results of autologous transplantation of fascia into the vocal fold, and to evaluate our use of autologous transpla ntation instead of bovine collagen injection in cases of glottal incompeten ce. Study Design: Retrospective study of the patients who have undergone au tologous fascia transplantation using our new technique. Methods: Follow-up studies were performed for at least 1 year (up to 3 y) on 9 autologous fas cia transplant patients (6 cases with type 1 procedures and 3 cases with ty pe 2 procedures), Clinical observations, including laryngeal stroboscopy, a nd measurement of maximum phonation time (MPT) were carried out. Results: D uring 3 months after autologous fascia transplantation, MPT gradually incre ased and stroboscopy showed improved glottal closure. These improvements co ntinued beyond 1 year in all cases of type 1 surgery and 2 of 3 cases of ty pe 2 surgery. Conclusions: Autologous transplantation of fascia into the vo cal folds as a phonosurgical treatment for glottal incompetence yields exce llent long-term results. Temporal fascia appears to be a highly suitable ti ssue for transplantation in Reinke's space. However, the fascia is less sui table for transplantation in the muscle. We speculate that transplantation of temporal fascia leads to regeneration of vocal fold tissue, perhaps usin g a mechanism similar to stem cell transplantation in other organs.