Endoscopic Management of Extruding Medialization Laryngoplasty Implants

Abstract

Medialization laryngoplasty (ML) is a commonly performed procedure for vocal fold motion impairment with glottic incompetence. Although implant extrusion is a well-known risk of ML, management of this complication is rarely mentioned in the literature. The aim of this study was to review our experience with endoscopic implant retrieval for a group of patients with extruding ML implants. All patients identified in our institution from January 1989 through August 2004 with a history of ML and extruded implants were identified. Case management was reviewed, including information on presentation, management techniques, and outcomes. Five patients presented with extruding ML (Gore-Tex [n = 2] or silastic [n = 3]) implants. All patients presented with worsening dysphonia and evidence of fullness and/or granulation tissue at the extrusion site. Endoscopic removal was performed using either sharp dissection or CO2 laser dissection. After removal, four patients underwent vocal fold injection augmentation. Endoscopic removal appears to be a safe, effective, and even preferred alternative to external transcervical removal in selected cases of extruding implants.