2004 Volume 16 Issue 2 Pages 127-130
The ideal injectable material for vocal fold medialization is biocompatible, not absorbable and non-migrating, and formulated for easy injection. In Japan, silicone, collagen, and autologous tissues such as fat and fascia are used as injectable materials. Silicone, however, causes foreign body reactions while collagen and autologous tissues have absorption problems.
BIOPEX is calcium phosphate cement, widely used for treating bone defects in orthopedic, neurosurgical, craniofacial surgical procedures and has proved to be biocompatible. A BIOPEX kit consists of a powder and liquid that, after mixing, is self-hardening (recrystallized to hydroxyapatite). We performed a basic study using rabbits for investigating suitability of BIOPEX as an injectable material. The study revealed that it was biocompatible and unabosorbable. We then commenced clinical application and have since performed 10 cases of injection laryngoplasty using BIOPEX. BIOPEX was injected using 2.5cc syringe with either a 16G long needle for microlaryngeal surgery or an 18G short needle for transcutaneous injection. In all cases, the injection procedure was accomplished safely and no acute foreign body reaction was observed. Although the follow-up period for the earliest case is not much longer than one year, CT and laryngoscopic observation revealed that BIOPEX has not been absorbed nor has it migrated. BIOPEX appeared to be suitable as an injectable material and could be utilized instead of conventional injectable materials.