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Journal of Case Reports
Medialization Laryngoplasty Implant Complication: Endolaryngeal Extrusion
Andrew James MacDonald1, Benjamin van der Woerd2, Kevin Fung2
1Schulich School of Medicine and Dentistry, Western University, Canada; 2Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada.
Corresponding Author:
Dr Kevin Fung
Email: kevin.fung@lhsc.on.ca
Received: 25-FEB-2020 Accepted: 15-JUL-2021 Published Online: 30-AUG-2021
DOI: http://dx.doi.org/10.17659/01.2021.0048
Background: In this case study, we describe a late complication of a Montgomery® medialization thyroplasty that has not been previously reported, and the surgical approach used for its intervention. Case Report: A 57-year-old gentleman who underwent a medialization laryngoplasty with a Montgomery® implant 3 years previously to treat idiopathic left sided vocal fold paralysis presented with sudden dysphonia following a robust coughing fit. His implant was observed extruding into the endolaryngeal lumen. Revision surgery consisted of implant removal through a transcervical approach and reconstructing the paraglottic space with fibrin glue (Tissel®) and an autologous free fat graft. Post-operative airway and voice outcomes were excellent, and the patient was decannulated prior to discharge. One-month post-operative voice outcomes were modest [Voice handicap index (VHI)-10 = 30]. Conclusion: This report describes a previously unreported complication of medialization thyroplasty of an intraluminal extrusion of a Montgomery implant and a novel surgical approach for repair. 
Keywords : Dysphonia, Hoarseness, Laryngoplasty, Prostheses and Implants, Vocal Cord Paralysis.
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