Autologous transplantation of fascia into the vocal fold as a treatment for recurrent nerve paralysis.

Abstract

To apply the technique of autologous transplantation of fascia graft into the vocal fold for glottal insufficiency due to recurrent nerve paralysis and to evaluate the results in eight patients who underwent the procedure. Technical modifications were made in transplantation of the temporal fascia into the paralyzed vocal fold. Eight patients underwent the surgery, and their phonatory function was examined preoperatively and postoperatively. The following surgical techniques were applied to prevent the falling-off of the graft: 1) a roll-shaped fascia graft was prepared before the transplantation and 2) a pocket was made within the lamina propria mucosa using a newly devised special elevator. The maximum phonation time and airflow rate during sustained phonation (in four cases) were measured, and perceptual evaluation of voice quality was made using the GRBAS scale by speech pathologists before and after the surgery. All the cases showed no evidence of falling-off of the graft. Elongation of the maximum phonation time and improvement in voice quality were obtained in all cases postoperatively. The method proved to be useful for the treatment of glottal insufficiency due to recurrent nerve paralysis.