Strap Muscle Type I Thyroplasty After Gore‐Tex Implant Extrusion: Case Report and Literature Review
Section snippets
INTRODUCTION
Implant extrusion is a rare but serious complication of type I thyroplasty that has been reported to occur with an incidence of 0.8%.1 Most commonly, implants extrude through the laryngeal introitus with rare extrusion through the pyriform sinus.2, 3 Extrusions associated with Gore-Tex and silastic implants usually arise within the first few months following surgery and can be attributed to suboptimal placement, coughing bouts, intubation trauma, inflammation, or infection.4 Options for
CASE REPORT
A 41-year-old female first grade teacher presented to the Wexner Medical Center at The Ohio State University for evaluation of sudden-onset dysphonia of 6 weeks duration. Her change in voice began with an upper respiratory illness with symptoms including pressure, tightness, and mild pain in her throat. She denied any dyspnea, dysphagia, cough, or throat clearing. She had a history of left vocal fold paralysis following total thyroidectomy which was treated with a Gore-Tex type I Thyroplasty
DISCUSSION
We present a case that is unique in two aspects; first, the extrusion occurred 41 months following initial Gore-Tex thyroplasty which is among the longest postoperative period reported in the literature. We discovered only three reports of Gore-Tex implant extrusion of longer durations, with extrusions observed at 49 months, 60 months, and 120 months, respectively.5, 6, 7 These reports indicate that potentially severe, airway obstructing complications can occur at remarkably late postoperative
CONCLUSION
Although rare, implant extrusion can occur even years after type I Thyroplasty and thus, surgeons should maintain a high level of suspicion in a patient with the appropriate risk factors and clinical presentation. Many options exist for vocal fold augmentation following implant removal. This is the first description of using a strap muscle graft for this purpose. The patient's excellent long-term outcomes highlight the need for further investigation of this technique in the management of
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Cited by (4)
[Translated article] Pericardial Mesh Migration Through the Airway After Extended Lower Bilobectomy
2022, Archivos de BronconeumologiaPericardial Mesh Migration Through the Airway After Extended Lower Bilobectomy
2022, Archivos de BronconeumologiaThe Utility of Strap Muscle in Complex Type I Thyroplasties
2021, Journal of VoiceCitation Excerpt :One has demonstrated the use of a bipedicled strap muscle flap in a total of 32 patients with VF atrophy, with or without sulcus vocalis.10 The other was a case report that utilized the sternohyoid muscle as a free graft.11 All seven of our patients presented after undergoing a type I thyroplasty procedures performed by outside laryngologists, and some had also undergone further medialization procedures.
Revisions and complications with Gore-Tex medialisation laryngoplasty: A 19-year experience
2021, Clinical Otolaryngology
Presented at Triological Society Annual Meeting at Combined Otolaryngology Spring Meetings, May 20–21, 2016, Chicago, Illinois.
The authors have no funding, financial relationships, or conflicts of interest to disclose.