[Medialization of paralysed vocal cord by expansive polytetrafluoroethylene implant (Gore-Tex)]

We report a technique for medialization of a paralyzed vocal cord using a Gore-Tex (expanded polytetrafluoroethylene) implant inserted under local anesthesia via a cervical incision. Gore-Tex is an expanded form of Teflon. It is used in vascular surgery (vessel repair) and esthetic surgery (particularly to increase lip volume). In esthetic surgery, the development of inflammatory processes difficult to control have been observed with teflon and appear to be less frequent with Gore-Tex due to the absence of free particles in the expanded form. The minimally invasive technique is simple and reproducible and can be performed under local anesthesia. We report a series of 9 cases operated from October 1995 to October 1997. During this period, this technique predominated (two other patients had Teflon injections). Excepting one case of extrusion of the implant material, vocal results were very satisfactory, based on both subjective and objective analysis of vocal parameters. The contribution of this technique in comparison with the reference endoscopic techniques (Teflon, collagen) and surgical techniques (silicone, cartilage) is discussed. Early results would suggest that Gore-Tex implantation can be used in the more severe forms due to vocal cord paralysis in the lateral position.