TEFLON VOCAL FOLD AUGMENTATION - FAILURES AND MANAGEMENT IN 28 CASES

Although vocal fold augmentation by Teflon injection has been the main stay of treatment for glottic insufficiency for three decades, the suc cess and safety of this treatment have been overstated. Twenty-eight p atients who manifested poor or complicated Teflon results between 1984 and 1991 were evaluated using acoustic, aerodynamic, videostroboscopi c, perceptual, and subjective patient self-evaluation of voice, both b efore and after our management of these complications. Most of these h ad Teflon granulomas; subglottic overfilling was the most common condi tion. In most instances such management included microsurgical removal of the Teflon granuloma. Voice measures that were abnormal before cor rection tended to improve and move into the normal range, although the resultant voices were not totally normal. Degree of improvement varie d depending on the Teflon-induced tissue changes and the methods of co rrection subsequently used. The worst results were in patients with sc arring, atrophy, and bilaterally mobile vocal folds, for whom Teflon s hould never have been injected. Teflon injection should be reserved fo r those instances in which it is clearly indicated and the surgeon is skilled in the technique of intrafold injection.