CASE REPORT   

Otorinolaringologia 2018 December;68(4):166-9

DOI: 10.23736/S0392-6621.18.02183-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Fat injection under local anesthesia in the treatment of chronic postsurgical dysphagia

Francesco OTTAVIANI ¹, Antonio SCHINDLER ², Francesco KLINGER ³, Carlo ROBOTTI ², Andrea ALBERA ¹, Francesco MOZZANICA ^{1, 2} ✉

¹ Division of Otorhinolaryngology, Department of Clinical Sciences and Community Health, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Milan, Italy; ² Phoniatric Unit, Department of Biochemical and Clinical Science “Luigi Sacco”, University of Milan, Milan, Italy; ³ Division of Plastic and Reconstructive Surgery, IRCCS Multimedica, Milan, Italy

In this study we describe the first application of functional fat injection (FFI) performed under local anesthesia in the treatment of chronic dysphagia secondary to head and neck cancer (HNC) surgery. FFI was performed in a sitting position using a transcervical approach. At the same time, a trans-nasal flexible endoscopic examination was performed in order to control the depth and site of fat injection. The effect of surgery was evaluated using videofluoroscopy (VFS), Fiberendoscopic Evaluation of Swallowing (FEES), and Eating Assessment Tool-10 (EAT-10). Before the FFI the VFS and FEES revealed a moderate impairment of swallowing abilities with aspiration with liquid and semisolid textures. The EAT-10 scored 29. Twelve months after surgery the VFS demonstrated mild dysphagia, the FEES demonstrated aspiration only with liquids and the EAT-10 improved. FFI under local anesthesia could be useful in the treatment of chronic dysphagia in selected patients.

KEY WORDS: Deglutition disorders - Head and neck neoplasms - Surgery - Anesthesia, local