{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T13:36:50Z","timestamp":1782481010616,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>There is a debate regarding the durability of fat implants. Our experience and recent publications suggest fat implantation may deliver a long\u2010lasting improvement. This study aims to present the long\u2010term outcomes for vocal fold fat augmentation using strict harvesting, preparing, and implantation protocols.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A prospective cohort conducted between 2014 and 2020 (recruitment 2014\u20102017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>An academic tertiary referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Twenty\u2010two patients with glottic insufficiency were enrolled: 11 had unilateral vocal fold paralysis (UVFP), and 11 had atrophy or scar. Harvested fat was injected unilaterally or bilaterally into multiple sites. Six of these patients also had simultaneous microlaryngoscopic removal of other benign glottic lesions. Outcome measurements included video stroboscopy; Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) score; Voice Handicap Index (VHI); and acoustic analysis, performed preoperatively, 3, 12, 24, and 36\u00a0months after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten augmentations were unilateral and 12 bilateral. Comparing the preoperative and 36\u2010month postoperative periods, the mean VHI score improved from 73.45 (\u00b122.78) to 44.88 (\u00b128.93), <jats:italic>P<\/jats:italic> =. 001, and the mean GRBAS decreased from 8.64 (\u00b13.89) to 2.82 (\u00b12.3), <jats:italic>P<\/jats:italic> =. 001; 24\u00a0months postoperatively, the mean fundamental frequency decreased from 163.88\u00a0Hz (\u00b141.61) to 150.44\u00a0Hz (\u00b141.47), <jats:italic>P<\/jats:italic> =. 012. Stroboscopic analysis revealed statistically significant improvement in mucosal wave propagation, phase closure, and phase symmetry. Best results were achieved in the UVFP subgroup. Computed tomography scans demonstrated long\u2010term viability of the implanted adipose tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fat is an excellent source of autologous graft. With careful patient selection and proper surgical technique, fat is suitable for long\u2010term correction of glottic insufficiency. Fat augmentation should be considered as a long\u2010lasting or even permanent solution, rather than temporary.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820947000","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T04:03:12Z","timestamp":1597118592000},"page":"631-638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Vocal Fold Fat Augmentation for Atrophy, Scarring, and Unilateral Paralysis: Long\u2010term Functional Outcomes"],"prefix":"10.1002","volume":"164","author":[{"given":"Yonatan","family":"Lahav","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Kaplan Medical Center Rehovot Israel"},{"name":"Faculty of Medicine The Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liron","family":"Malka\u2010Yosef","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Kaplan Medical Center Rehovot Israel"},{"name":"Faculty of Medicine The Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Shapira\u2010Galitz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Kaplan Medical Center Rehovot Israel"},{"name":"Faculty of Medicine The Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oded","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Kaplan Medical Center Rehovot Israel"},{"name":"Faculty of Medicine The Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doron","family":"Halperin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Kaplan Medical Center Rehovot Israel"},{"name":"Faculty of Medicine The Hebrew University Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagit","family":"Shoffel\u2010Havakuk","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Rabin Medical Center Petach\u2010Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02824.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200006000-00026"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200105000-00001"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20126"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-200312000-00013"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.03.012"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016487509121353"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1622.1999.01613.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(01)00015-7"},{"key":"e_1_2_9_11_1","first-page":"1","article-title":"Montgomery thyroplasty implant system","volume":"170","author":"Montgomery WW","year":"1779","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310201104"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2010.08.001"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199902000-00020"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(87)80035-8"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.2008.34253.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199702000-00008"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199205000-00005"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-003-0622-y"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949510401109"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-4725.2000.00278.x"},{"key":"e_1_2_9_22_1","first-page":"117","volume-title":"Neurologic Disorders of the Larynx","author":"Ford CN"},{"key":"e_1_2_9_23_1","first-page":"219","volume-title":"Textbook of Laryngology","author":"Meyer T","year":"2006"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489415595427"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.125"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817739256"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199805000-00019"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199801000-00010"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200208000-00017"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24536"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2016.12.003"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2013.01.015"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2005.08.006"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20529"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949610500803"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3181735634"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000245013.98844.30"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.1991.101.4.344"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200207000-00017"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199805000-00019"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949910800101"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820947000","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599820947000","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820947000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:37:25Z","timestamp":1760967445000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599820947000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,11]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1177\/0194599820947000"],"URL":"https:\/\/doi.org\/10.1177\/0194599820947000","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,11]]},"assertion":[{"value":"2020-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}