[Description of complications after injection laryngoplasty with polydimethylsiloxane]

The injection of polydimethylsiloxane for medialization of the vocal folds has been used for more than 15 years with satisfactory long-term results. However there is little in the literature with regard to the complications and their treatment. We present 2 cases (1 unilateral laryngeal paralysis and 1 bilateral vocal fold atrophy) with unsatisfactory results after PDMS injection. The first case had chronic granulomatous inflammation induced by the PDMS and the second a periprothetic fibrotic reaction causing cordal rigidity. A superior cordotomy and extraction of the PDMS was performed in the two patients. A significant improvement was observed in the first patient (with granuloma); on the other hand the PDMS removal in the second case couldn't modify the cordal rigidity and consequently the voice quality. In conclusion, PDMS injection laryngoplasty is an efficient intervention with possible complications: foreign body granuloma, periprothetic fibrosis. In case of chronic inflammation, an endoscopic removal is indicated. Where there is vocal fold rigidity due to fibrosis the surgical correction is more difficult. For this reason an injection in Reinke's space or an over-correction must be avoided.