Displacement of Residual Gore-Tex Thyroplasty Implant Presenting as a True Vocal Fold Mass

Abstract

Objectives:

Describe the unique presentation and management of a patient with an ipsilateral true vocal fold mass following revision thyroplasty that was identified to have migration of residual Gore-Tex thyroplasty implant into the superficial lamina propria of the anterior true vocal fold.

Methods:

A single case of a patient who underwent revision type I thyroplasty after an unsuccessful attempt elsewhere using a Gore-Tex implant is reported. At the time of revision surgery, it was thought that all prior implant material was extricated, and the patient underwent revision type I thyroplasty using a carved silastic Netterville Implant with arytenoid adduction.

Results:

After initial improvement following the revision type I thyroplasty, the patient experienced deterioration of her voice. Indirect laryngeal examination revealed fullness on the superior surface of the right true vocal fold affecting mucosal wave and glottic closure. Microdirect laryngoscopy with endoscopic evaluation revealed migration of residual implant material into the superficial lamina propria. Using microflap technique, excision of the residual Gore-Tex thyroplasty implant was successfully performed with a combination of carbon dioxide laser and cold-dissection techniques.

Conclusions:

This case report describes the unique presentation of a displaced, non-extruded residual Gore-Tex thyroplasty implant, which presented as new onset dysphonia and mass involving the superior surface of the true vocal fold. This case demonstrates that displaced or migrated Gore-Tex thyroplasty implant material can be successfully removed endoscopically using a modified microflap technique.