Textured polydimethylsiloxane elastomers in the human larynx: Safety and efficiency of use

For the treatment of unilateral laryngeal paralysis with glottic insufficie ncy injection laryngoplasty is a popular modality of treatment. This proced ure augments the volume of the paralyzed vocal fold by endoscopic injection . However, the ideal substance has not yet been found for that purpose, We report for the first time the systematic application and long-term results of vulcanized polydimethylsiloxane (PDMS) particles in the treatment of glo ttic insufficiency in the human larynx. Of 10 patients treated with PDMS in the early 1990s, 7 patients could be retrieved for reevaluation. Laryngeal function was assessed by videostroboscopy, expert rating, and further char acterized by the objective parameters of voice profile and maximum phonatio n time, In a standardized questionnaire, all patients were asked for their personal impression of the results. Mean follow-up time was 88.4 months (ra nge 69-102 months). Glottic closure was complete in 5 of 7 patients, There were no signs of granuloma formation or of her pathologic changes of the in jected vocal folds. In 4 cases, voices were rated normal or near-normal; 2 voices were rated as fair; 1 usable. All the patients reported significant and lasting voice improvement. None of the patients reported any problems r elated to PDMS. PDMS particles provide permanent augmentation of human voca l fold volume without complications. Their use is a valuable and safe alter native when a definitive one-step procedure seems advantageous, However, fu rther studies are needed to assess voice improvement in comparison to other materials (C) 2000 John Wiley Be Sons, Inc.