Transnasal endoscopic microfractured fat injection in glottic insufficiency

Transnasal endoscopic microfractured fat injection in glottic insufficiency. Objective: We evaluated a novel treatment for glottic insufficiency involving the injection of autologous material with direct glottic visualisation in an outpatient setting. Methods: Three patients with vocal cord palsy underwent laryngoplasty under local anaesthesia using only a flexible endoscope with a working canal for Microfractured Fat Fibre-endoscopic Injection (MFFI). Adipose tissue was processed using the Lipogems® device, which allows optimal purity, fluidity, and mesenchymal stem cell content in the resultant emulsion. Results: According to the preliminary data, MFFI was well tolerated and no complications were observed. During the 12-month follow-up period, voice improvement was constant in all three patients, hinting at the stem cell-related regenerative potential of the procedure. Conclusions: MFFI was proven to be a useful and straightforward tool, combining all of the relevant advantages of other known treatments for glottic insufficiency, and is an efficacious and innovative treatment that can be performed on an outpatient basis using only autologous material.