Spontaneous displacement of silastic prosthesis 10 years after type 1 thyroplasty: a case report

Year 2009, Volume: 19 Issue: 5, 268 - 271, 23.10.2009

Sinan Kocatürk Güçlü Kaan Beriat Cem Doğan

Abstract

Implant dislocation following type 1 tyroplasty mostly results from the effects of triggering factors in the early postoperative period. A 42-year-old female patient who had had tyroplasty type 1 surgery with silastic implant, applied to our clinic with cough episodes, dyspnea and hoarseness following an upper airway infection 10 years after the surgery. In laryngeal endoscopic examination of the patient, white colored irregularity on anterior left vocal cord and left band ventricule fullness was seen. Regarding the patient’s medical history, it was thought that the silastic prosthesis which had been implanted in the type 1 thyroplasty surgery might have displaced. The silastic prosthesis was removed by means of microsurgery technique through endolaryngeal way under general anesthesia. During the first month follow-up of the patient, dyspnea and hoarseness complaints were improved right away and she had no other problems. The causes and consequences of displacement of the prothesis which rarely occurs, after tyroplasty type 1 have been discussed along with the latest data in the literature.

Keywords

Complication, implant extrusion, type 1 thyroplasty

Tip 1 tiroplastiden 10 yıl sonra spontan silastik protez kayması: Olgu sunumu

Abstract

Tip 1 tiroplasti sonrası implant yer değişimi sık- lıkla erken ameliyat sonrası dönemde tetikleyici faktörlerin etkisi ile ortaya çıkar. Tip 1 tiroplasti ameliyatı olan silastik implantlı 42 yaşında kadın hasta, ameliyattan 10 yıl sonra üst solunum yolu enfeksiyonu sonucu ortaya çıkan öksürük nöbetleri, dispne ve ses kısıklığı yakınmaları ile kliniğimize başvurdu. Hastanın endoskopik larenks muayenesinde sol vokal kord anteriyo- runda beyaz renkli düzensizlik ve sol bant ventri- külde dolgunluk görüldü. Hastanın öz geçmişi ile ilgili olarak tip 1 tiroplasti ameliyatında implante edilmiş olan silastik protez bloğun yer değiştirmiş olabileceği düşünüldü. Silastik protez mikrocer- rahi tekniği ile endolarengeal yoldan genel anes- tezi altında çıkarıldı. Hastanın bir aylık takibinde nefes darlığı ve ses kısıklığı yakınmaları hemen düzeldi ve başka sorunu olmadı. Tip 1 tiroplasti sonrasında nadir görülen protezin yer değiştirme- sinin nedenleri ve sonuçları son literatür verileri eşliğinde tartışıldı

Keywords

Komplikasyon, implant ekstrüzyonu, tip 1 tiroplasti

References

• Ford CN, Bless DM. Phonosurgery: assesment and surgical management of voice disorders. New York: Raven Press; 1991.
• Isshiki N, Morita H, Okamura H, Hiramoto M. Thyroplasty as a new phonosurgical technique. Acta Otolaryngol 1974;78:451-7.
• Kandoğan T. The role of thyroplasty in the manage- ment of sulcus vocalis. Kulak Burun Bogaz Ihtis Derg 2007;17:13-7.
• Naguib MB, Badr-Eldin M, Iskander N, Hassan I. Experimental autogenous cartilaginous grafts for lar- yngotracheoplasty: a comparison of two techniques and two different types of grafts. Kulak Burun Bogaz Ihtis Derg 2006;16:246-50.
• Woo P. Arytenoid adduction and medialization laryn- goplasty. Otolaryngol Clin North Am 2000;33:817-40.
• Cotter CS, Avidano MA, Crary MA, Cassisi NJ, Gorham MM. Laryngeal complications after type 1 thyroplasty. Otolaryngol Head Neck Surg 1995;113:671-3.
• Rosen CA, Murry T, DeMarino DP. Late complication of type 1 thyroplasty: a case report. J Voice 1999;13:417-23.
• Tucker HM, Wanamaker J, Trott M, Hicks D. Complications of laryngeal framework surgery (pho- nosurgery). Laryngoscope 1993;103:525-8.
• Mahieu HF, Norbart T, Snel F. Laryngeal framework surgery for voice improvement. Rev Laryngol Otol Rhinol (Bord) 1996;117:189-97.
• McCulloch TM, Hoffman HT, Andrews BT, Karnell MP. Arytenoid adduction combined with Gore- Tex medialization thyroplasty. Laryngoscope 2000; 110:1306-11.
• Montgomery WW, Blaugrund SM, Varvares MA. Thyroplasty: a new approach. Ann Otol Rhinol Laryngol 1993;102:571-9.
• Abraham MT, Gonen M, Kraus DH. Complications of type I thyroplasty and arytenoid adduction. Laryngoscope 2001;111:1322-9.
• Ford CN, Unger JM, Zundel RS, Bless DM. Magnetic resonance imaging (MRI) assessment of vocal fold medialization surgery. Laryngoscope 1995;105:498-504.
• Kumar VA, Lewin JS, Ginsberg LE. CT assessment of vocal cord medialization. AJNR Am J Neuroradiol 2006;27:1643-6.