2021 Volume 72 Issue 3 Pages 132-137
Thyroplasty type I (TP I)uses an artificial material to medialize the paralyzed vocal fold. There have been reports of prolapse of artificial materials as a late complication. We report two cases of GORE-TEX deviating into the pharynx after TP I. Case 1 was a 69-year-old man who underwent arytenoid adduction and TP I for vocal cord paralysis after surgery for esophageal cancer. Three years later, throat discomfort appeared, and GORE-TEX protruding from the piriform sinus into the hypopharynx was observed. It was orally removed under general anesthesia. Case 2 was a 67-year-old man who underwent TP I for vocal fold paralysis caused by a traffic accident. Six months after the operation, GORE-TEX was visible in the piriform sinus. At 11 months after the operation, it was orally removed under general anesthesia. In the original TP I method, the general rule is to preserve the cartilage piece of the window and the inner perichondrial membrane. However, in order to medialize the posterior portion of the vocal fold, the inner perichondrial membrane may be ruptured and the thyroarytenoid muscle or the arytenoid cartilage itself may be moved inward or rotated. The risk of the artificial material escaping to the pharynx should be kept in mind when artificial material is translocated across the inner perichondrial membrane in TP I.
