On the complexity matching and multiscale nonlinear perspective of voice restoration via fat injection laryngoplasty in unilateral vocal fold paralysis

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Voice disorders represent a common medical condition affecting up to 16.9% of the general population, with unilateral vocal fold paralysis (UVFP) being particularly severe. This condition causes breathy dysphonia, maladaptive articulatory behaviours, and cortical alterations in sensory processing. Although injection laryngoplasty (IL) is considered an effective minimally invasive treatment, traditional acoustic analysis often does not provide robust metrics to evaluate its effectiveness. Here, a multiscale nonlinear approach, including the concept of complexity matching computed through the correlation of scaling factors obtained from Multi-Fractal Detrended Fluctuation Analysis, is introduced to better detect improvements in vocal fold vibratory patterns and vocal tract resonance in 69 UVFP patients, treated by autologous fat IL. This method revealed that mildly recovered (MR) patients show stronger similarity of physiological complex characteristics between pre- and post-operative conditions than fully recovered ones. This outcome shows agreement between perceptual and objective evaluations, indicating that the chaotic properties of voice production are still preserved in the MR group. This finding could assist clinicians in recognising patients requiring further treatment, fostering a patient-centred care approach. Moreover, sample entropy (SE) emerged as the most reliable p

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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