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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 1, pp 255–261 | Cite as

Complications of using Gore-Tex in medialization laryngoplasty: case series and literature review

  • Kenichi WatanabeEmail author
  • Ai Hirano
  • Yohei Honkura
  • Kazutaka Kashima
  • Masayuki Shirakura
  • Yukio Katori
Miscellaneous
  • 89 Downloads

Abstract

Purpose

This study was performed to evaluate the incidence and contributing factors of complications associated with medialization laryngoplasty using Gore-Tex in patients with unilateral vocal fold paralysis.

Methods

A retrospective chart review was conducted for all patients who underwent medialization laryngoplasty using Gore-Tex at Tohoku University Hospital between January 2014 and April 2018. A search of series and case reports in PubMed was performed to determine the incidence of complications following medialization laryngoplasty using Gore-Tex.

Results

Sixty-eight patient charts were reviewed. Two patients (2.9%) had complications (infection and extrusion into the airway) related to the Gore-Tex implant after surgery. In the 555 medialization laryngoplasty cases reported in both our current data and eight additional articles, there were 11 complications related to the Gore-Tex implant (2.0%). The most common event was extrusion into the lumen, which occurred in six cases (1.1%), followed by persistent inflammation with the granulation formation (0.5%). There were 12 cases of Gore-Tex extrusion (one male, six female, and five of unknown gender). The interval to onset ranged from 1 month to 10 years (median, 49 months).

Conclusions

Our findings serve as a reminder that complications can occur with Gore-Tex implants following medialization laryngoplasty in patients with unilateral vocal fold paralysis, even in the long-term. We suggest that the use of excessively large implants in women and occurrence of postoperative hematoma followed by infection are factors that may cause complications. Nevertheless, Gore-Tex has been proven to be a relatively safe and reliable material for medialization laryngoplasty.

Keywords

Medialization laryngoplasty Gore-Tex Unilateral vocal fold paralysis Type I thyroplasty Extrusion Airway compromise 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    Isshiki N, Okamura H, Ishikawa T (1975) Thyroplasty type I (lateral compression) for dysphonia due to vocal cord paralysis or atrophy. Acta Otolaryngol 80:465–473CrossRefGoogle Scholar
  2. 2.
    McCulloch TM, Hoffman HT (1998) Medialization laryngoplasty with expanded polytetrafluoroethylene. Surgical technique and preliminary results. Ann Otolrhinol Laryngol 107:427–432CrossRefGoogle Scholar
  3. 3.
    Young VN, Zullo TG, Rosen CA (2010) Analysis of laryngeal framework surgery: 10-year follow-up to a national survey. Laryngoscope 120:1602–1608CrossRefGoogle Scholar
  4. 4.
    Rajkumar K, Khalil HS, Elloy M et al (2005) Histopathological changes in the human larynx following expanded polytetrafluroethylene (Gore-Tex®) implantation. BMC Ear Nose Throat Disord 5:1–6CrossRefGoogle Scholar
  5. 5.
    Cashman S, Simpson CB, McGuff HS (2002) Soft tissue response of the rabbit larynx to Gore-Tex implants. Ann Otol Rhinol Laryngol 111:977–982CrossRefGoogle Scholar
  6. 6.
    Greene D, Pruitt L, Corey SM (1997) Biomechanical effects of e-PTFE implant structure on soft tissue implantation stability: a study in the porcine model. Laryngoscope 107:957–962CrossRefGoogle Scholar
  7. 7.
    Isshiki N (2000) Progress in laryngeal framework surgery. Acta Otolaryngol 120:120–127CrossRefGoogle Scholar
  8. 8.
    Cohen JT, Bates DD, Postma GN (2004) Revision Gore-Tex medialization laryngoplasty. Otolaryngol Head Neck Surg 131:236–240CrossRefGoogle Scholar
  9. 9.
    Feinberg S, Lopez-Guerra G, Zeitels SM (2010) Hypopharyngeal extrusion of 2.5 feet (76 cm) of polytetrafluoroethylene (Gore-Tex): initial laser-assisted office-based removal and micropharyngeal completion. Ann Otol Rhinol Laryngol 119:573–577CrossRefGoogle Scholar
  10. 10.
    Herbst A (1999) Extrusion of an expanded polytetrafluoroethylene implant after rhinoplasty. Plast Reconstr Surg 104:295–296CrossRefGoogle Scholar
  11. 11.
    Jin H-R, Lee J-Y, Yeon J-Y, Rhee C-S (2006) A multicenter evaluation of the safety of Gore-Tex as an implant in Asian rhinoplasty. Am J Rhinol 20:615–619CrossRefGoogle Scholar
  12. 12.
    Conrad K, Torgerson CS, Gillman GS (2008) Applications of Gore-Tex implants in rhinoplasty reexamined after 17 years. Arch Facial Plast Surg 10:224–231CrossRefGoogle Scholar
  13. 13.
    McCulloch TM, Hoffman HT, Andrews BT, Karnell MP (2000) Arytenoid adduction combined with Gore-Tex medialization thyroplasty. Laryngoscope 110:1306–1311CrossRefGoogle Scholar
  14. 14.
    Mortensen M, Carroll L, Woo P (2009) Arytenoid adduction with medialization laryngoplasty versus injection or medialization laryngoplasty: the role of the arytenoidopexy. Laryngoscope 119:827–831CrossRefGoogle Scholar
  15. 15.
    Tokashiki R, Hiramatsu H, Tsukahara K et al (2007) A “fenestration approach” for arytenoid adduction through the thyroid ala combined with type I thyroplasty. Laryngoscope 117:1882–1887CrossRefGoogle Scholar
  16. 16.
    Rosen C (1998) Complications of phonosurgery: results of a national survey. Laryngoscope 108:1697–1703CrossRefGoogle Scholar
  17. 17.
    Halum SL, Postma GN, Koufman JA (2005) Endoscopic management of extruding medialization laryngoplasty implants. Laryngoscope 115:1051–1054CrossRefGoogle Scholar
  18. 18.
    Cotter CS, Avidano MA, Crary MA et al (1995) Laryngeal complications after type 1 thyroplasty. Otolaryngol Head Neck Surg 113:671–673CrossRefGoogle Scholar
  19. 19.
    Abraham MT, Gonen M, Kraus DH (2001) Complications of type I thyroplasty and arytenoid adduction. Laryngoscope 111:1322–1329CrossRefGoogle Scholar
  20. 20.
    Krane NA, Hu A, Sataloff RT (2016) Gore-Tex extrusion following type I thyroplasty. Ear Nose Throat J 95:138–140CrossRefGoogle Scholar
  21. 21.
    Chang J, Schneider SL, Curtis J et al (2017) Outcomes of medialization laryngoplasty with and without arytenoid adduction. Laryngoscope 127:2591–2595CrossRefGoogle Scholar
  22. 22.
    Giovanni A, Vallicioni J-M, Gras R, Michel Z (1999) Clinical experience with Gore-Tex for vocal fold medialization. Laryngoscope 109:284–288CrossRefGoogle Scholar
  23. 23.
    Friedrich G (1999) Titanium vocal fold medializing implant: Introducing a novel implant system for external vocal fold medialization. Ann Otol Rhinol Laryngol 108:79–86CrossRefGoogle Scholar
  24. 24.
    Matsushima K (2015) Investigation of Type I thyroplasty using titanium implant. Nihon Jibiinkoka Gakkai Kaiho 118:1027–1036CrossRefGoogle Scholar
  25. 25.
    Yumoto E, Sanuki T, Toya Y et al (2010) Nerve-muscle pedicle flap implantation combined with arytenoid adduction. Arch Otolaryngol Head Neck Surg 136:965–969CrossRefGoogle Scholar
  26. 26.
    Chao TN, Mahmoud A, Rajasekaran K, Mirza N (2018) Medialisation thyroplasty with tensor fascia lata: a novel approach for reducing post-thyroplasty complications. J Laryngol Otol 132:364–367CrossRefGoogle Scholar
  27. 27.
    Tucker HM, Wanamaker J, Trott M, Hicks D (1993) Complications of laryngeal framework surgery (phonosurgery). Laryngoscope 103:525–528Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology, Head and Neck SurgeryTohoku University Graduate School of MedicineSendaiJapan

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