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Revision Gore-Tex medialization laryngoplasty
Jacob T Cohen1, Dwight D Bates, Gregory N Postma
1Department of Otolaryngology, Center for Voice and Swallowing Disorders of Wake Forest University, Winston-Salem, North Carolina, USA.
Objective:
To evaluate the indications, results, and safety of revision Gore-Tex medialization laryngoplasty (GML).
Methods:
A retrospective chart review of 156 patients that underwent GML procedures between the years 1998-2002. Study population consisted of those patients who required revision surgery for any reason.
Results:
Sixteen patients required 22 revision procedures. Indications for revision were divided into 2 groups, complications and glottal closure problems. Complications included extruded or displaced implants (n = 4). The most common glottal closure problem was undercorrection (n = 9). Others included anterior overcorrection (n = 1) and persistent posterior glottal gap (n = 2). Revision procedures included GML (n = 9), injection augmentation (n = 9), endoscopic implant removal (n = 2), and arytenoid adduction (n = 2). In patients with glottal closure problems, the GCI improved in all 10 and the voice rating scale improved in 9.
Conclusion:
Reasons for revision of GML are variable, the most common being undercorrection. A variety of safe, effective revision techniques are available with a high success rate.