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

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.