Giant teflon granuloma of the larynx

Abstract

Endolaryngeal injection of Teflon paste to augment and medialize the paralyzed hemilarynx aims to improve dysphonia and relieve aspiration. After an initial short-lived inflammatory reaction in the laryngeal tissues, a foreign body granuloma forms around the Teflon. In most cases the results are good but it may occasionally be necessary to consider removal of the granuloma if too large a volume has been injected, if it is inappropriately placed, or if the paralyzed vocal cord subsequently recovers. Surgical removal is difficult and the results are unpredictable. This case illustrates, for the first time, that evaluation using both a high-resolution computed tomographic (CT) scan and endoscopy with telescopes permits satisfactory assessment before removal of Teflon.

A novel silk‐based vocal fold augmentation material: 6‐month evaluation in a canine model

“…Unwanted device migration can potentially lead to patient complications and require unintended touchup VFI procedures or adverse events. Prior negative experiences with Teflon paste as a VFI material causing delayed onset granuloma formation in the TVF are widely recognized . Consequently, resulting dysphonia and dyspnea in many patients has left the otolaryngology community with a heightened sense of hesitation when accepting novel VFI materials.…”

“…Prior negative experiences with Teflon paste as a VFI material causing delayed onset granuloma formation in the TVF are widely recognized. [3][4][5]15 Consequently, resulting dysphonia and dyspnea in many patients has left the otolaryngology community with a heightened sense of hesitation when accepting novel VFI materials. Due to its comparable laryngeal size to humans, 14 the canine vocal fold accommodates a fixed volume injection and incremental photographs over the course of the study.…”

“…Of those, autologous fat, Teflon, and CaHA exhibit enhanced retention, lasting longer than 12 months after implantation . Although Teflon is considered a permanent material, its documented history of adverse events, especially granulomas in the vocal fold at the site of injection, has rendered it a significant risk for VFI and has resulted in removal from the commercial market . Autologous fat also demonstrates enhanced longevity and is considered permanent by many; however, the more involved material collection and processing in a sterile fashion precludes in‐office fat injection augmentation in most centers …”

“…1,2 Although Teflon is considered a permanent material, its documented history of adverse events, especially granulomas in the vocal fold at the site of injection, has rendered it a significant risk for VFI and has resulted in removal from the commercial market. [3][4][5] Autologous fat also demonstrates enhanced longevity and is considered permanent by many; however, the more involved material collection and processing in a sterile fashion precludes in-office fat injection augmentation in most centers. 6 CaHA suspended in a CMC carrier gel (CaHA-CMC) has overcome many of the aforementioned obstacles to emerge as a successful long-lasting material for VFI.…”