Vocal Cord Scarring—Structural Response to Autologous Adipose Tissue–Derived Stromal Vascular Fraction (ADSVF) Injection

Vocal cord scarring can be disabling and resistant to treatment. Stem cell treatment might be effective but is expensive and requires weeks to culture. In contrast, autologous ADSVF refers to a mix of cells (mesenchymal stem cells [MSCs] or adipose-derived stem cells [ADSCs]), fibroblasts, leukocytes, endothelial cells, and progenitors and pericytes) that can be harvested in hours from enzymatic digestion of adipose. Experimental and clinical reports suggest ADSVF has antifibrotic effects, mainly attributed to the stem cell fraction. Researchers assessed the feasibility of using ADSVF for treatment of vocal cord scarring in a phase 1 clinical trial and concluded the treatment was safe and potentially effective. This videolaryngostroboscopy video shows its effects in a patient with congenital scarring (sulcus). Before treatment, the patient’s vocal folds showed scarring with an absence of vibration in the middle third and insufficient glottic closure. A year after ADSVF injection, the vibration of the middle third of vocal folds was improved (mucosal wave was clearly visible) with near-complete glottic closure. Click the related article link for a complete discussion of the intervention and of other patients’ outcomes.