Migration of Cymetra after vocal fold injection for laryngeal paralysis

Injection laryngoplasty is a common operative technique used in the management of unilateral vocal fold paralysis. Cymetra is a micronized particulate injectable form of acellular human dermis that is commonly used for vocal cord medialization procedures. We report migration of an intracordal bolus of Cymetra into the medial wall of the pyriform sinus. Histopathology from endoscopic resection of the migrated Cymetra demonstrated a localized foreign body reaction with characteristic giant cells. Specific anatomic considerations through cadaveric laryngeal dissection are presented to demonstrate the likely pathway of intralaryngeal bolus migration.