Magnetic Resonance Imaging of Micronized Dermal Graft in the Larynx

Abstract

Objectives:

This study was conducted to evaluate magnetic resonance imaging (MRI) as an objective measure of survival of micronized acellular human dermal graft (Cymetra, LifeCell Corporation) injected into the thyroarytenoid muscle for augmentation of unilateral vocal fold paralysis.

Methods:

We performed a retrospective review of MRI scans obtained in 6 patients in whom Cymetra was injected into the thyroarytenoid muscle. Gadolinium-enhanced MRI of the larynx was performed 3 days, 1 month, 8 months, 11 months, 15 months, and 21 months after injection. The survival of injected Cymetra was assessed according to information obtained from the MRI scan. Images were also obtained for 1 cm³ of reconstituted Cymetra paste.

Results:

The identification of Cymetra in the larynx is based on its proteinaceous content. T1-weighted images of the injected material in the true vocal fold showed hyperintense foci corresponding to injected Cymetra. Hyperintense signal was also present on the T2-weighted images. Persistence of the injected Cymetra was readily detectable by MRI for as long as 11 months.

Conclusions:

Cymetra is a viable treatment option for vocal fold augmentation. The duration of survival of Cymetra (as long as 11 months) makes it a good option in cases in which longer survival of the injectable material is needed.