Complications of Thyroplasty Type I with Montgomery Implant

Abstract

Objective: Document the incidence and risk factors for significant complications in patients with a unilateral laryngeal nerve paralysis managed with thyroplasty type I and Montgomery implant insertion.

Method: Inception cohort of 181 patients with 104 patients followed for a minimum of 12 months or until death. Data regarding significant complication were obtained at regular visits to our clinic. Univariate analysis was performed for potential statistical relation between the complications noted and various variables.

Results: The intraoperative and postoperative course was unremarkable in 85.6% and 92.3% of cases. No patient died from the procedure. Significant complications included Montgomery implant replacement by a Gore-tex implant (7), difficulty to stabilize the implant (8), misplacement of the implant (3), hematoma (8), severe dyspnea (5), and extrusion of the implant (5). A 5.5% revision rate was found (10/181). No significant statistical relation was noted between the complications noted and the variables under analysis.

Conclusion: The reported data suggest that the Montgomery implant insertion is a safe technique with a low incidence for complication. The lack of a statistically significant difference between senior and junior surgeons also suggests the absence of a learning curve in this procedure.