Outcomes of Vocal Folds Injection with Autologous Fat Plus Platelet-Rich Plasma in Cases of Glottic Gap

Background: Glottic insufficiency, sometimes referred to as glottic gap, is a prevalent etiology of dysphonia, manifesting as a soft voice, diminished projection, and vocal fatigue. Aim: To confirm the outcomes of vocal fold injection with autologous fat plus Platelet–Rich Plasma on patients with glottic insufficiency. Methods: A prospective cohort study was conducted on 60 cases of glottis gap; cases had been categorized into two equal groups: Group A: complained of dysphonia without choking and exposed to injection of vocal folds with autologous fat plus Platelet-Rich Plasma(the subjects’ group). Group B: complained of dysphonia without choking and not exposed to injection of vocal folds, but exposed to voice therapy two sessions per week for three months(control group). Results: After one-month and three-month follow-up, Group A revealed significant improvements across multiple voice parameters compared to Group B. Fundamental frequency(Fo) increased consistently over time. Measures of vocal stability, such as jitter and shimmer percentages, showed marked reductions. Additionally, the Noise-to-Harmonic Ratio decreased progressively. Maximum phonation time(MPT) also improved substantially. Furthermore, the Voice Handicap Index(VHI) scores exhibited a steady decline. Group A showed significant improvements in all voice parameters at one to three months post-treatment compared to pre-treatment, while Group B did not exhibit significant changes in voice parameters across the pre-treatment, one-month, and three-month assessments. Conclusions: Fat combined with PRP injections results in enhanced softening of the vocal folds, improved vibratory function, and superior mucosal wave activity, hence enhancing voice quality more than with voice therapy alone. Fat combined with PRP is linked to prolonged enhanced functionality, as evidenced by acoustic analysis through the computerized speech lab(CSL).