Teflon vocal fold augmentation: failures and management in 28 cases

Area of Science:

• Otolaryngology
• Speech-Language Pathology

Background:

• Teflon injection has been a primary treatment for glottic insufficiency for 30 years.
• The reported success and safety of Teflon injection may be overestimated.
• Complications and suboptimal outcomes necessitate re-evaluation of the procedure.

Purpose of the Study:

• To evaluate the outcomes of managing complications arising from Teflon vocal fold augmentation.
• To assess voice quality changes before and after corrective interventions for Teflon-related issues.
• To identify factors influencing the degree of voice improvement after complication management.

Main Methods:

• Retrospective evaluation of 28 patients with poor or complicated Teflon injection results (1984-1991).
• Assessment included acoustic, aerodynamic, videostroboscopic, perceptual, and subjective voice evaluations.
• Management often involved microsurgical removal of Teflon granulomas and addressing subglottic overfilling.

Main Results:

• Most patients presented with Teflon granulomas or subglottic overfilling.
• Voice measures improved post-correction, moving towards normal ranges, but not always achieving complete normalization.
• Significant improvement depended on the extent of Teflon-induced tissue damage and the corrective techniques used.

Conclusions:

• Teflon injection for glottic insufficiency requires careful consideration due to potential complications.
• Microsurgical management can improve voice outcomes in cases of Teflon granulomas and overfilling.
• The procedure should be reserved for clearly indicated cases performed by skilled surgeons, avoiding patients with scarring, atrophy, or mobile folds.