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 transplantation instead of bovine collagen injection in cases of glottal incompetence. STUDY DESIGN: Retrospective study of the patients who have undergone autologous fascia transplantation using our new technique. METHODS: Follow-up studies were performed for at least 1 year (up to 3 y) on 9 autologous fascia transplant patients (6 cases with type 1 procedures and 3 cases with type 2 procedures). Clinical observations, including laryngeal stroboscopy, and measurement of maximum phonation time (MPT) were carried out. RESULTS: During 3 months after autologous fascia transplantation, MPT gradually increased and stroboscopy showed improved glottal closure. These improvements continued beyond 1 year in all cases of type 1 surgery and 2 of 3 cases of type 2 surgery. CONCLUSIONS: Autologous transplantation of fascia into the vocal folds as a phonosurgical treatment for glottal incompetence yields excellent long-term results. Temporal fascia appears to be a highly suitable tissue for transplantation in Reinke's space. However, the fascia is less suitable for transplantation in the muscle. We speculate that transplantation of temporal fascia leads to regeneration of vocal fold tissue, perhaps using a mechanism similar to stem cell transplantation in other organs.