Vocal fold
paralysis results from various etiologies and can induce voice changes, swallowing complications, and issues with aspiration. Vocal fold
paralysis is typically managed using injection
laryngoplasty with fat or synthetic
polymers. Injection with autologous fat has shown excellent biocompatibility. However, it has several disadvantages such as unpredictable resorption rate, morbidities associated with
liposuction procedure which has to be done in operating room under
general anesthesia. Human adipose-derived extracellular matrix (ECM) grafts have been reported to form new adipose tissue and have greater biostability than autologous fat graft. Here, we present an
injectable hydrogel that is constructed from adipose tissue derived soluble extracellular matrix (sECM) and
methylcellulose (MC) for use in vocal fold augmentation. Human sECM derived from adipose tissue was extracted using two major steps-ECM was isolated from human adipose tissue and was subsequently solubilized.
Injectable sECM/MC
hydrogels were prepared by blending of sECM and MC. Sustained vocal fold augmentation and symmetric vocal fold vibration were accomplished by the sECM/MC
hydrogel in paralyzed vocal fold which were confirmed by
laryngoscope, histology and a high-speed imaging system. There were increased number of
collagen fibers and fatty granules at the injection site without significant
inflammation or
fibrosis. Overall, these results indicate that the sECM/MC
hydrogel can enhance vocal function in paralyzed vocal folds without early resorption and has potential as a promising material for injection
laryngoplasty for stable vocal fold augmentation which can overcome the shortcomings of autologous fat such as unpredictable duration and morbidity associated with the fat harvest.