Injection laryngoplasty with micronized dermis: A 10-year experience with 381 injections in 344 patients

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: Micronized Dermis (MD) has been used for injection laryngoplasty for correction of glottic insufficiency since 2000. There is controversy whether the material is temporary or permanent. This is a retrospective review of 381 injections in 344 patients. From this review, we hope to better define the role of MD in injection laryngoplasty. Method: Retrospective chart review from a single surgeon (2000-2010) Results: The indications for MD were for both temporary and permanent correction of glottic insufficiency. The diagnoses were: vocal fold paralysis (n = 216), scar (n = 51), atrophy (n = 42), sulcus (n = 22), and others (n = 13). The material has the best effect when placed into the membranous vocal fold just lateral to the vocal ligament. The operative and postoperative complication was 1.05%. Twenty-nine percent of all injections resulted in unwanted absorption. Overinjection was needed and transcervical approach was preferred to prevent implant extrusion with overinjection. The median volume of injected material has increased from 0.8 cc to 1.0 cc over the decade. In 159 patients with long-term follow-up (>1 year), there was a 14% incidence of reinjection. Despite this, the overall need for open procedures in patients with long-term follow-up was 20%. Conclusions: Despite the problems of inconsistency in preparation, slow absorption and need for overinjection, micronized dermis is a safe allograft material that has long-term (>1 year) stability. The material may reduce the need for open surgery. It can be used for both temporary and permanent vocal fold augmentation.

Original languageEnglish (US)
Pages (from-to)2460-2466
Number of pages7
JournalLaryngoscope
Volume120
Issue number12
DOIs
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Laryngoplasty
Vocal Cords
antineoplaston A10
Dermis
Injections
Tongue
Paralysis
Atrophy
Cicatrix
Allografts
Incidence

Keywords

  • alloderm
  • cymetra
  • dermis
  • glottic
  • injection
  • insufficiency
  • laryngoplasty
  • Micronized

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Injection laryngoplasty with micronized dermis : A 10-year experience with 381 injections in 344 patients. / Tan-Geller, Melin; Woo, Peak.

In: Laryngoscope, Vol. 120, No. 12, 12.2010, p. 2460-2466.

Research output: Contribution to journalArticle

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abstract = "Objective: Micronized Dermis (MD) has been used for injection laryngoplasty for correction of glottic insufficiency since 2000. There is controversy whether the material is temporary or permanent. This is a retrospective review of 381 injections in 344 patients. From this review, we hope to better define the role of MD in injection laryngoplasty. Method: Retrospective chart review from a single surgeon (2000-2010) Results: The indications for MD were for both temporary and permanent correction of glottic insufficiency. The diagnoses were: vocal fold paralysis (n = 216), scar (n = 51), atrophy (n = 42), sulcus (n = 22), and others (n = 13). The material has the best effect when placed into the membranous vocal fold just lateral to the vocal ligament. The operative and postoperative complication was 1.05{\%}. Twenty-nine percent of all injections resulted in unwanted absorption. Overinjection was needed and transcervical approach was preferred to prevent implant extrusion with overinjection. The median volume of injected material has increased from 0.8 cc to 1.0 cc over the decade. In 159 patients with long-term follow-up (>1 year), there was a 14{\%} incidence of reinjection. Despite this, the overall need for open procedures in patients with long-term follow-up was 20{\%}. Conclusions: Despite the problems of inconsistency in preparation, slow absorption and need for overinjection, micronized dermis is a safe allograft material that has long-term (>1 year) stability. The material may reduce the need for open surgery. It can be used for both temporary and permanent vocal fold augmentation.",
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