声带沟的诊断及治疗

目的　探讨声带沟的分型及治疗方法。方法　 2 9例声带沟患者按有无声嘶及沟的形态分为 3型 :Ⅰ型 :生理型 ,11例 (无声嘶 ) ;Ⅱ型 :裂线型 ,13例 ;Ⅲ型 :局凹型 ,5例 ;后两种为病理型声带沟 ,有声嘶。对有声嘶 18例进行了手术及术后嗓音训练治疗 ,手术方法有 :①黏膜下分离自体脂肪注射术 (Ⅱ型 9例 ,Ⅲ型 2例 ,其中 1例为术式②疗效不佳再手术者 ) ;②黏膜切开挖槽自体脂肪注射术(Ⅱ型 4例、Ⅲ型 1例 ) ;③声带沟切除术 (Ⅲ型 4例 ,包括 1例术式①疗效不佳再手术者 )。所有患者均随访 6个月以上 ,平均为 15 3个月。结果　喉镜及嗓音分析发现 ,13例Ⅱ型患者中 10例 (其中 6例为黏膜下分离自体脂肪注射术 ,占该术式 6 /9;4例为黏膜切开挖槽自体脂肪注射术 ,占该术式 4 /4) ,术后 3个月声带沟消失 ,发音良好 ,声带振动恢复 ;另 3例单行黏膜下分离自体脂肪注射术者 ,术后声带沟变浅 ,仍稍声嘶。 5例Ⅲ型患者中 3例行声带沟切除术后 4～ 5个月声带沟消失 ,发音时声门闭合好 ,声带振动恢复 ;另 2例先单行黏膜下分离自体脂肪注射术或黏膜切开挖槽自体脂肪术者 ,术后 10d～ 3个月声带沟再现 ,再次手术后好转。结论　对声带沟患者应分型后采用不同治疗方法 ,黏膜切开挖槽自体脂肪注射术对Ⅱ型治疗效果最好 ,声     

经环甲间隙自体阔筋膜加脂肪声带注射治疗单侧声带麻痹

目的 观察经环甲间隙自体阔筋膜加脂肪声带注射治疗周围性单侧声带麻痹的效果.方法在全麻支撑喉镜下,对12例周围性单侧声带麻痹患者经环甲间隙声带注射自体阔筋膜加脂肪,评估注射前后声带位置、声嘶改善状况及声学参数变化.结果 12例患者术后声嘶明显改善,最大声时延长.动态喉镜检查患侧声带移向正中位,声门闭合良好,3个月后注射侧声带体积保持稳定,未发现任何并发症.结论经环甲间隙自体阔筋膜加脂肪声带注射治疗单侧声带麻痹简单安全、疗效确切.     

声带沟的诊断及治疗

目的探讨声带沟的分型及治疗方法。方法29例声带沟患者按有无声嘶及沟的形态分为3型：Ⅰ型：生理型，11例(无声嘶)；Ⅱ型：裂线型，13例；Ⅲ型：局凹型，5例；后两种为病理型声带沟，有声嘶。对有声嘶18例进行了手术及术后嗓音训练治疗，手术方法有：①黏膜下分离自体脂肪注射术(Ⅱ型9例，Ⅲ型2例，其中1例为术式②疗效不佳再手术者)；②黏膜切开挖槽自体脂肪注射术(Ⅱ型4例、Ⅲ型1例)；③声带沟切除术(Ⅲ型4例，包括1例术式①疗效不佳再手术者)。所有患者均随访6个月以上，平均为15．3个月。结果喉镜及嗓音分析发现，13例Ⅱ型患者中10例(其中6例为黏膜下分离自体脂肪注射术，占该术式6／9；4例为黏膜切开挖槽自体脂肪注射术，占该术式4／4)，术后3个月声带沟消失，发音良好，声带振动恢复；另3例单行黏膜下分离自体脂肪注射术者，术后声带沟变浅，仍稍声嘶。5例Ⅲ型患者中3例行声带沟切除术后4～5个月声带沟消失，发音时声门闭合好，声带振动恢复；另2例先单行黏膜下分离自体脂肪注射术或黏膜切开挖槽自体脂肪术者，术后10d～3个月声带沟再现，再次手术后好转。结论对声带沟患者应分型后采用不同治疗方法，黏膜切开挖槽自体脂肪注射术对Ⅱ型治疗效果最好，声带沟切除术对Ⅲ型治疗最合适。     

单侧声带麻痹的外科治疗

目的比较颈袢喉返神经吻合术与声带外侧自体软骨充填术、声带脂肪注射术的疗效。方法单侧声带麻痹143例,病程6个月至12年。行颈袢与喉返神经吻合术(A组)89例：声带外侧自体软骨充填术(B组)25例;声带自体脂肪注射术(C组)29例。治疗前后以电子喉镜、频闪喉镜、声音评估和嗓音声学参数分析等评价治疗效果。结果A组术后术侧声带均内移至正中位,肌体积增大,发音时声带突明显内收,声门后裂隙消失,声带振动及黏膜波均恢复对称性,声门闭合良好：嗓音恢复正常86例。3例接近正常;声学五参数频率微拢、振幅微拢、标准化嗓音能量、基频及最长声时平均值均在正常范围内,前三项明显小于术前,后两项明显大于术前,差异均具有非常显著性。B组及C组术后声带均不同程度内移,但声带均无运动,声门后裂隙仍较明显。B、C组术后声嘶有不同程度好转,声学前三参数平均值均明显小于术前,最长声时明显大于术前,差异均具有显著性：而基频手术前后差异无显著性。B、C组的声学参数前三项均明显大于A组,而基频及最长声时明显小于A组,差异均具有显著性。B、C组间的声学五参数差异无显著性意义。结论单侧声带麻痹以神经修复术疗效最佳;声带外侧充填术及声带脂肪注射术也有治疗效果,不适合神经修复者仍可选用：脂肪注射术往往须多次注射方能维持疗效。     

显微支撑喉镜下手术治疗沟状声带

目的探讨显微支撑喉镜下应用黏膜微瓣技术治疗沟状声带的疗效。方法对31例Ⅱ型或Ⅲ型沟状声带患者在显微支撑喉镜下切除声带沟底病变,采用黏膜微瓣技术缝合修复创面。手术前、后,应用动态喉镜观察声带形态、声门闭合情况及黏膜波变化特点,应用Dr.Speech4.0软件进行嗓音客观参数声学分析。结果所有病例均一次手术成功,无术后并发症。31例患者术后1个月发声改善明显,术后6个月音质稳定,嗓音声学参数与术前比较差异有统计学意义(P<0.01)。动态喉镜检查声带形态接近正常,声门闭合改善,黏膜波接近正常。随访1～3年,音质稳定。结论显微支撑喉镜下黏膜微瓣技术治疗沟状声带有利于声带黏膜创面愈合,减少疤痕形成,利于发声功能恢复。     

声带外侧自体脂肪注射填充术治疗声门闭合不良

目的对声带外侧自体脂肪注射填充术方法选择、预后及其影响因素进行研究,探讨声带外侧自体脂肪注射在声门闭合不良性发声障碍治疗中的价值。方法病例选择:29例声门闭合不良、发声障碍患者,27例为单侧声带麻痹(麻痹时间均超过半年),2例为声带萎缩。手术选择:全麻支撑喉镜下,应用特制Brunning高压脂肪注射器进行自体脂肪声带外侧注射。患者手术前后均行嗓音声学、气流动力学及频闪喉镜检查,确定患者发音质量及疗效。结果术后随诊10～18个月,24例患者发声明显改善,2例发声好转,3例无效。注射1个月后脂肪部分吸收,声门闭合程度及发音逐渐改善。3～6个月声带振动、声门闭合正常,发声明显改善,音质稳定,主、客观声学评价及气流动力学参数改善明显(P<0.01)。结论单侧声带麻痹或声带萎缩引起的声门闭合不良,选择声带外侧声门旁间隙脂肪注射手术,使声带膜部内移,改善声门闭合,并保留声带振动特性,患者可获得良好的发音效果。     

电子喉镜下脂肪注射术治疗单侧声带麻痹

目的 探讨电子喉镜监控下声带黏膜下自体脂肪注射术治疗单侧声带麻痹的疗效.方法 32例单侧声带麻痹患者,取自体脂肪颗粒在电子喉镜监控下自环甲膜穿刺,患侧声带内多角度分层次多点注射,术前、术后即刻、术后6个月、术后12个月分别测量患侧声带的表面积和声门裂隙大小,嗓音质量评估仪对嗓音进行评估.结果注射术后麻痹侧声带表面积增加,声门裂隙缩小,随时间推移,麻痹侧声带内的脂肪部分吸收,声带表面积减小,声门裂隙稍增大,术后各阶段和术前比较差异有显著性统计学意义;但术后6个月和术后12个月比较差异无显著性意义.嗓音声学测试发现,术后声门噪声能量下降,声时延长,与术前比较差异有显著性统计学意义;术后6个月和术后12个月比较,差异无显著性意义.结论电子喉镜下声带黏膜下自体脂肪注射术方法简单、方便,疗效确切,是治疗单侧声带麻痹的有效方法.     

激光治疗喉癌前病变

目的在手术治疗喉癌前病变的同时,最大限度的保留和恢复喉的正常发音功能。方法应用激光外科手术治疗喉癌前病变77例,其中采用声带黏膜上皮层切除术治疗声带黏膜白斑及轻度不典型增生23例;采用声带黏膜剥脱术治疗中、重度不典型增生44例;激光切除成人型喉乳头状瘤10例。结果23例声带黏膜白斑及轻度不典型增生者术后2个月发音恢复正常;44例中、重度不典型增生者术后3～5个月发音逐渐恢复正常;10例喉乳头状瘤患者术后发音明显优于经颈进路手术的发音。结论嗓音显微外科手术既能分层切除声带病变,又能最大限度的保留和恢复喉的发声功能,是治疗喉癌前病变首选的微创性方法。     

自体脂肪声带内注射术治疗单侧声带麻痹的远期疗效观察

目的　探讨自体脂肪声带内注射术治疗单侧声带麻痹的远期疗效。方法　 2 0例单侧声带麻痹患者将取自体腹部的脂肪颗粒注射到麻痹侧声带 ,使声带隆起 ,声门闭合 ,恢复嗓音功能 ;所有病例均随访 12个月以上 ,并按术前及术后即刻、近期 (3～ 6个月 )、远期 (>12个月 )通过电子喉镜以计算机软件测得患侧与健侧声带上表面面积比为参数代表患侧声带大小变化指标 ,并用嗓音疾病评估仪进行嗓音声学测试分析。按术前嗓音声学测试结果分为轻度、中度、重度 3组 ,采用自身对照统计分析结果。结果　注射后麻痹侧声带相应体积较术前明显增大 ,但随时间推移 ,麻痹侧声带内的脂肪部分吸收 ,麻痹侧声带体积逐渐减小 ,而术后近期各组及远期中重度声嘶组测得的麻痹侧声带相应体积与术前差异有显著性 ,轻度声嘶组远期测得的麻痹侧声带相应体积与术前差异无显著性。声学测试客观分析 ,注射后较注射前嘶哑程度明显好转 ,随时间延长嘶哑程度有所下降 ,但术后近期及远期嘶哑程度接近。直接反映声门闭合程度的噪声能量在注射脂肪后较注射前明显下降 ,达到正常或接近正常 ;随时间延长噪声能量稍升高 ,但与术前差异有显著性 ,且术后近期及远期的差异无显著性。结论　自体脂肪声带内注射治疗单侧声带麻痹是可选择的有效方法 ,其远期     

喉良性增生性病变的嗓音学特点及治疗转归

目的 :探讨喉良性增生性病变对发声功能的影响及CO2 激光显微外科术后的转归特点。方法 :对2 92例喉良性增生性病变患者 (声带息肉、任克水肿、声带小结、囊肿、慢性肥厚性喉炎 )的流行病学、嗓音声学、形态及CO2 激光显微外科术后转归进行分析。结果 :声带小结患者均为青年女性 ,2 3.0 8%与职业有关 ;任克水肿为中老年患者。声带息肉及小结病变局限 ,手术仅涉及声带局部 ,术后改善明显 ,术后 1个月达正常状态 ;任克水肿患者术后 1个月改善明显 ,术后 3个月恢复最佳稳定 ;声带囊肿患者术后 1个月声音达最佳状态 ,但由于病变切除术后局部存在缺损 ,一定程度上影响预后 ;慢性肥厚性喉炎患者术后改善不满意。术后声门上代偿纠正均不明显。结论 :喉良性增生性病变主要累及声带被覆层 ,嗓音声障碍的程度及疗效与受累范围有关 ,激光显微外科手术可以保留良好结构及功能。除外科治疗外 ,还应及时矫正不良发声习惯等因素 ,以期获得最佳疗效。     

Carbon dioxide laser microsurgery of benign vocal fold lesions: indications, techniques, and results in 251 patients

Two hundred fifty-one carbon dioxide laser-assisted cases of microphonosurgery are reported. Our series includes 167 women (66.5%) and 84 men (33.5%), with a mean age of 41 (+/-11) years. Single lesions represent 67.8% (n = 170) of the cases, with 20% (n = 50) being nodules, 18% (n = 44) Reinke's edema, 9% (n = 23) polyps, 8% (n = 19) sulci and related lesions, 6% (n = 16) mucosal cysts, 4% (n = 10) scars, 2% (n = 4) granulomas, and 2% (n = 4) vascular corditis. The cases with 2 or 3 lesions represented 32% (n = 81). Carbon dioxide laser-assisted microphonosurgery is efficient, provided the working parameters are strictly adhered to: micromanipulator micropoint providing a 250-microm laser beam for a 400-mm working distance; 0.1-second single pulses; and maximum power of 3 W with the superpulse wave. Glutaraldehyde-cross-linked collagen remains our filling material of choice in cases of vocal fold atrophy. Fibrin glue is useful for covering the resection area and for setting the microflaps. Microphonosurgery cannot be dissociated from speech therapy, the planning and duration of which, in relation to the procedure, depend on the nature of the initial lesion. Twenty to 30 sessions are usually adequate, but 6 months may be necessary in the case of sulcus vergetures. Our operating technique is derived from the microphonosurgery procedures with cold instruments. In addition to the classic advantage with regard to hemostasis, the carbon dioxide laser micropoint seems to make the dissection of microflaps easier.     

自体筋膜移植填充治疗声带沟

目的探讨筋膜移植填充术在声带沟治疗中的价值及预后转归。方法23例双侧声带沟患者全麻显微镜下行声带沟瘢痕松解、筋膜移植填充手术，合并声带肌萎缩者同时行声门旁间隙脂肪注射。患者手术前、后行嗓音声学、气流动力学及频闪喉镜检查。结果4例手术失败者未进行疗效评价。19例术后6—8周患者发音开始改善，术后3个月发音改善明显。术后6个月音质趋于稳定，主、客观声学评价及气流动力学参数较术前改善明显，17例（89．5％）患者音质改善明显，声带结构及黏膜振动接近正常，声门闭合明显改善；2例患者音质改善不明显，声带形态接近正常，声门闭合改善，但黏膜振动不良。声音嘶哑主观评分与术前比较改善明显（P值均〈0．05），总评分2例患者（10．5％）提高2个等级，15例患者（79．0％）提高1个等级，2例患者（10．5％）评级无明显改变。除基频外，嗓音声学参数及最大发音时间与术前比较差异均有统计学意义（P值均〈0．01），8例（42．0％）患者声学参数达到正常范围，17例患者（89．5％）最大发音时间达到正常范围。19例患者随诊均6个月-1年，未发现筋膜吸收，其中5例患者随诊满2年，音质稳定。结论筋膜移植填充声带沟的手术可在一定程度上矫正声带固有层缺陷，改善声门闭合不良，恢复声带振动特性。     

Results with collagen injection into the vocal folds for medialization

PURPOSE OF REVIEW: This review outlines the indications, surgical techniques and follow-up, with results, for current collagen use. RECENT FINDINGS: Micronized AlloDerm (Cymetra) is a presently available injectable substance made from human collagen and elastin particles. A mean follow-up of 8-10.5 months showed lasting results after injection for vocal fold immobility. Collagen injection is one possible method for treating a vocal fold scar - or sulcus -vergeture by medialization of one or both of the scarred vocal folds. Collagen injection laryngoplasty is presently the treatment of choice for presbyphonia if speech therapy is insufficient. Collagen injection for Parkinson-related dysphonia is an effective temporary method of subjectively improving voice and speech in selected patients. Laryngeal collagen injection can also permit further medialization of one or both vocal folds after medialization thyroplasty. SUMMARY: Injection laryngoplasty with micronized AlloDerm, a presently available homologous collagen, remains a suitable option for the treatment of vocal fold immobility with a moderate gap. Collagen injection is also efficient for sulcus vergetures, scars and presbyphonia, and can help in cases of Parkinson's disease. Complications are uncommon but patients must be advised that the stability of results is unpredictable. Collagen injection can be repeated and does not prevent other surgical solutions.     

Histological study of injected autologous fascia in the paralyzed canine vocal fold

OBJECTIVE: Several methods have been used for the treatment of the unilateral paralyzed vocal fold. Teflon injections have been used extensively but not without complications. The ideal substance for injection is yet to be determined. Injected autologous fascia has been reported as a means of achieving glottic closure. In review of the literature, there are no long-term results described using autologous fascia in this way. The purpose of this study was to examine the histological changes of the larynx after injection of autologous fascia into a paralyzed vocal fold. STUDY DESIGN: A prospective study with the contralateral side of the larynx used as the control. METHODS: Six adult dogs underwent severing of one of their recurrent laryngeal nerves. After the vocal folds were confirmed to be paralyzed by direct laryngoscopy, fascia lata that was harvested from the animal was minced and injected into the paralyzed vocal fold. The dogs were then killed at intervals ranging from 3 to 12 months and their larynges reviewed histologically. RESULTS: The larynges revealed muscle atrophy of the vocal fold, which is consistent with denervation, but there was no evidence of persistent fascia. In addition, there was no evidence of reaction to the injected fascia. Special stains for collagen were also performed which showed no significant change from the non-injected vocal fold. CONCLUSION: From this model, it is concluded that injected autologous minced fascia is not a good short- or long-term substance for vocal fold augmentation. Further study is warranted to confirm this observation.     

自体筋膜加脂肪声带注射术治疗声门闭合不全的疗效观察

目的 探讨自体筋膜加脂肪声带注射术治疗声门闭合不全的疗效.方法 对26例单 侧声带麻痹声门闭合不全患者全麻支撑喉镜下经口行声带内注射术,其中6例采用自体脂肪注射(A组),20例采用自体腹直肌前鞘筋膜加脂肪注射(B组).术前、术后动态喉镜检查和主客观嗓音分析评估疗效,均随访24个月.结果 两组患者术后注射物无外溢,注射侧声带形态饱满;术后3 d注射侧声带出现急性炎性反应,3个月左右消退.术后3个月A组所有患者注射侧声带回复至中线,声门闭合良好,6～24个月声门闭合稍有缝隙;B组所有患者术后6个月回复至中线,声门闭合良好,6～24个月声带形态稳定.术前嗓音声学分析:两组间基频微扰、振幅微扰、标准化噪声能量及最大发音时间差异无统计学意义(P值均＞0.05);A组术后3个月显著改善(P值均＜0.01),6及24个月较术前改善(P值＜0.05或＜0.01),但较术后3个月音质下降(P值＜0.05或＜0.01);B组术后6个月显著改善(P值均＜0.01),6、12及24个月各参数差异均无统计学意义(P值均＞0.05);术后24个月两组的基频微扰、标准化噪声能量及最大发音时间差异有统计学意义(P值＜0.05或＜0.01).B组嗓音听感知评估,总嘶哑度、气息声、发音无力程度评分降低,与术前相比差异有统计学意义(P值均＜0.01).结论 自体腹直肌前鞘筋膜加脂肪声带内注射术治疗单侧声带麻痹声门闭合不全可有效提高患者声音质量,远期效果稳定.

Abstract：

Objective To evaluate the effect of combination of autologous fascia and fat injection into vocal fold for the treatment of patients with unilateral vocal fold paralysis and to observe the long-term effectiveness of this procedure. Methods A total of 26 unilateral vocal fold paralysis patients underwent vocal fold injection under general anesthesia, meanwhile, the mucosa of the injected point was sutured through laryngoscope under direct vision. There were 6 patients underwent autologous fat injection into vocal fold ( group A), and 20 patients underwent autologous anterior rectus sheath fascia and fat injection ( group B). Therapeutic efficacy were evaluated by videostroboscopy, voice-related parameters analysis and voice evaluation before and after treatment. Clinical analysis of this procedure was retrospectively performed in this serial of patients. Results All patients were followed up for 24 months. On the third day after operation,there was an acute inflammatory reaction induced by the graft. This reaction disappeared three months later.In all 20 eases, videolaryngostroboscopy showed significant improvement of the glottic closure, the improvement in acoustical parameters was statistically significant ( P ＜ 0. 01 ). Perceptual evaluation of GRBAS scale showed significant improvement of phonatory function on G, B, A scale. The results remained stable 6 -24 months after operation and were not changed by the length of follow-up. And in the 6 cases,videolaryngostroboscopy showed significant improvement of the glottic closure at 3 months compared with preoperative observation, a little spindle-shaped disclosure. The improvement in acoustical parameters was significant statistically at 3, 6 and 24 months (P ＜ 0. 05 or ＜ 0. 01 ), the voice quality decreased significantly at 6 and 24 months compared with 3 months (P ＜0. 05 or ＜0. 0l ). The significant differences were not observed between 6 and 24 months (P ＞ 0. 05 ). No complications were observed in all patients perioperatively or during the follow-up period. Voice-related parameters jitter, normalized noise energy and maximum phonation time showed significant differences between Group A and Group B on 24 months ( P ＜0. 05 or ＜ 0. 01 ). Conclusion The combination of autologous fascia and fat vocal fold injection is an effective procedure for the treatment of unilateral vocal fold paralysis, and the stable results can be achieved during the follow-up period for 24 months.     

Use of Freeze-dried Autologous Fascia to Augment the Vocal Fold: An Experimental Study in Dogs

This study assessed the practicality of using autologous freeze-dried fascia to augment the vocal fold. Freeze-dried autologous fascia was injected into the vocal fold and skin of dogs in order to monitor sequential histological changes. Fascia lata was harvested from six adult dogs. After freeze-drying, minced fascia suspended in hyaluronic acid was injected subcutaneously into the abdominal wall and directly into the vocal fold. The specimens were extracted 3 weeks after injection and studied histologically. Freeze-drying destroyed all cellular components but did not affect the collagen fibers, which are the major components of fascia. There was no evidence of degeneration, necrosis or infection. Fibroblastic infiltration was seen in the fascia injected into the vocal fold, but the fascia remained as an unencapsulated mass at the site of injection. This study demonstrates that freeze-drying does not compromise the collagen in fascia and that the injection of freeze-dried collagen is well tolerated. Freeze-dried fascia is a promising new augmentation material.     

Use of freeze-dried autologous fascia to augment the vocal fold: an experimental study in dogs

This study assessed the practicality of using autologous freeze-dried fascia to augment the vocal fold. Freeze-dried autologous fascia was injected into the vocal fold and skin of dogs in order to monitor sequential histological changes. Fascia lata was harvested from six adult dogs. After freeze-drying, minced fascia suspended in hyaluronic acid was injected subcutaneously into the abdominal wall and directly into the vocal fold. The specimens were extracted 3 weeks after injection and studied histologically. Freeze-drying destroyed all cellular components but did not affect the collagen fibers, which are the major components of fascia. There was no evidence of degeneration, necrosis or infection. Fibroblastic infiltration was seen in the fascia injected into the vocal fold, but the fascia remained as an unencapsulated mass at the site of injection. This study demonstrates that freeze-drying does not compromise the collagen in fascia and that the injection of freeze-dried collagen is well tolerated. Freeze-dried fascia is a promising new augmentation material.     

Processing of fascia for vocal fold injection. A study in vitro and in paralyzed canine vocal folds

To evaluate the simplest and safest method to mince fascia for autologous vocal fold injection, we performed an in vitro study applying porcine fascia and a prospective study using a canine model. Six different surfaces were tested in the laboratory for mincing fascia. The ease of handling of tissue on each surface was noted. Minced fascia was studied by microscope under polarized illumination, and the number and nature of foreign particles were recorded. After the safest method to mince fascia was established, 2 dogs were operated on. The recurrent nerve was sectioned, and a piece of fascia lata was harvested and cut with scissors on a steel surface. Fascia injection deep into the thyroarytenoid muscle was performed. The dogs were painlessly sacrificed 6 months later, and the larynges were removed for histomorphological study. On cutting, all polymer surfaces released small amounts of particles. These were not evident when we used glass or steel plates, but their hard surfaces were difficult to work on. Cutting a piece of fascia with scissors was found to be effective and safe in terms of microscopic foreign particles. The two dogs suffered no perioperative or late complications. Six months later, a well-preserved, vascularized, collagen-rich tissue was in its place without any evidence of acute or chronic inflammation. The histomorphological findings were identical to those of our previous study, with the exception that this time, no foreign particles from the mincing surface were present. An autologous fascia graft proves to be well preserved and well tolerated in the augmentation of a paralyzed vocal fold, and scissors are simple and effective in mincing it for injection.