2022 Volume 73 Issue 4 Pages 273-278
Type 4 thyroplasty (TP4) is a technique for raising speaking fundamental frequency (SFF). Traction sutures increase the tension of the vocal fold by closing the thyroid cartilage and cricoid cartilage, and the sutures are fixed by GORE-TEX® (GT). However, use of artificial materials sometimes results in infection. Here we report a case of infectious granuloma 13 years after TP4. The case was a 78-year-old male. He was diagnosed with male to female gender identity disorder in 200X. To increase his SFF, he underwent TP4 in 200X＋1. In 200X＋14, he came to us with complaint of an infectious mass, and an infectious granuloma was found on the neck skin. GT was found in the anterior commissure. The patient's voice profiles were G2R2B2, SFF 269 Hz, jitter coefficient 4.43%, shimmer coefficient 7.87%, NHR 19.6 dB, and VHI 63/120. The granuloma, GT, and traction thread sutures were removed under general anesthesia. The thyroid cartilage showed a perforation into the laryngeal lumen, and it was covered with the strap muscles. After the removal operation, the voice profiles did not change and the SFF was not decreased. Over a long time period the cricothyroid joint became fixed after traction sutures removal, the SFF was unchanged. If infection occurs around artificial materials, they should be removed in order to control the infection.
