Migration and Granulomatous Reaction After Periurethral Injection of Polytef (Teflon)

Malizia, Anthony A.; Reiman, Herbert M.; Myers, Robert P.; Sande, Jonathan R.; Barham, Steven S.; Benson, Ralph C.; Dewanjee, Mrinal K.; Utz, William J.

doi:10.1001/jama.1984.03340480059030

Cited by 417 publications

(91 citation statements)

References 24 publications

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“…PTFE paste injection resulted in particle migration to distant organs, such as the lungs and brain. [22][23][24][25] Although collagen is not likely to migrate, collagen did not conserve the initial volume 26,27 and sometimes caused allergic reactions or viral infections. 28 Silicone has been reported to have severe complications, such as chronic inflammation or migration.…”

Section: Introductionmentioning

confidence: 99%

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

et al. 2006

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The injection of bulking substances has been proposed as a new therapy to treat urinary incontinence and vesicoureteral reflux. Our previous study demonstrated that poly(lacticco-glycolic acid) (PLGA) microspheres have the potential to serve as a bulking agent for urological injection therapies. Hybrid tissues exhibiting a bulking effect were formed in vivo by PLGA microsphere injection, but long-term volume stability was not proven. In this study, we hypothesized that the biodegradation rate of the bulking substance (polymer microspheres) would affect the duration of volume conservation of the induced hybrid tissue. To test this hypothesis, rapidly degrading 75:25 PLGA microspheres and slowly degrading poly(L-lactic acid) (PLLA) microspheres were used as injectable bulking agents for the injection therapy. In vitro degradation tests showed that the mass losses of PLLA and PLGA were 16 and 96% of the initial masses, respectively, at 30 weeks. PLLA and PLGA microspheres were injected into the subcutaneous dorsum of mice. Both types of microspheres were easily injectable through 24-gauge needles. Histological examinations at various time points indicated that host cells from the surrounding tissues migrated to the spaces between both types of injected microspheres and formed new hybrid tissue structures. Lymphocyte migration was noted around the implanted PLGA and PLLA microspheres, but the inflammatory reaction diminished with time. Importantly, the volume of the PLLA hybrid tissues slowly decreased to 52% of the initial volume at 12 months and maintained that volume until 18 months, whereas the volume of the PLGA hybrid tissues rapidly decreased to 22% at 6 months, and the PLGA hybrid tissues disappeared at 11 months. These results show that the biodegradation rate of the bulking substance may be useful for controlling the duration of volume conservation of the induced hybrid tissue.

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Section: Introductionmentioning

confidence: 99%

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

et al. 2006

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“…(range [3][4][5][6][7][8]. The average volume of GAX collagen injected into the females was 54 cc compared to an average of 55 cc among the males.…”

Section: Resultsmentioning

confidence: 99%

Collagen injections for intrinsic sphincter deficiency in the neuropathic urethra

et al. 1995

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Twelve subjects experiencing stress urinary incontinence caused by spinal injury or myelomeningocele were treated by periurethral injection of a bulking agent, glutaraldehyde cross-linked (GAX) collagen. Of the 11 subjects who completed the program, seven were either cured or improved and four were only slightly improved or no better following injection. The valsalva (abdominal) leak point pressure (LPP) rose an average of 57 cm H20 (pre-treatment mean of 60 cm H20 versus post-treatment mean of 117 cm H20) and none of the patients experienced significant complications during the mean follow-up period of 24 months. Every subject injected was able to maintain an intermittent catheterization program after treatment. These data support the use of GAX collagen as an alternative or adjunct therapy to pharmacotherapy, surgical reconstruction or implantation of a prosthesis in the management of stress urinary incontinence in the neuropathic urethra.

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“…However, it was soon observed that Teflon Ò does not remain in place but migrates, and it leads to chronic inflammation and granulomas of the foreign body type. Therefore, nowadays the use of Teflon Ò is opposed [3].…”

Section: Discussionmentioning

confidence: 99%

“…In these patients injection laryngoplasty is a safe and easy method. Since its introduction 1911 by Brüning (cited as quoted in [1]), a range of substances such as paraffin, autologous fat tissue, fascia, gelatin, calcium hydroxylapatite, hyaluronan acid, and Teflon Ò has been tried and most of them were abandoned due to resorption, migration, or complications [2,3].…”

Section: Introductionmentioning

confidence: 99%

The Use of Polydimethylsiloxane for Injection Laryngoplasty

Hagemann

Seifert

2008

World j. surg.

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Background Injuries of the recurrent laryngeal nerve with consecutive vocal cord paralysis is a typical complication in chest, esophageal, thyroideal, and neck surgery. Glottic insufficiency secondary to such a lesion can be treated by endolaryngeal vocal cord augmentation (injection laryngoplasty). Many different substances have been used, often showing complications or disadvantages. This study reports on the use of injectable polydimethylsiloxane (PDMS), with special regard to the long-term results. Methods In this prospective study, 21 patients with unilateral vocal cord paralysis underwent injection laryngoplasty using PDMS at a volume of 0.5-1.0 ml. Preoperatively, 6 weeks and 12 months after the injection the following parameters concerning patients' voice were evaluated: Glottic closure by videolaryngostroboscopy, maximum phonation time, voice range, voice dynamic, jitter, shimmer, noise-toharmonic-ratio, and roughness, breathiness, and hoarseness (RBH). In addition, patients were asked to give their own evaluation of how satisfied they felt with their voice and of the handicaps it caused them. Results Postoperatively an improvement was evident in all the parameters that were investigated, and this significant improvement was still in evidence for most of the parameters more than one year after the injection. In our study no complications were observed more than one year after injection. Conclusion PDMS is a safe substance for injection laryngoplasty in unilateral vocal cord paresis. Objective and subjective parameters confirm its effectiveness. It is suitable for obtaining satisfying results in the reestablishment of the patient's voice and communication ability.

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Migration and Granulomatous Reaction After Periurethral Injection of Polytef (Teflon)

Cited by 417 publications

References 24 publications

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

Collagen injections for intrinsic sphincter deficiency in the neuropathic urethra

The Use of Polydimethylsiloxane for Injection Laryngoplasty

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