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CT assessment of vocal cord medialization.
AJNR Am J Neuroradiol. 2006 Sep; 27(8):1643-6.AA

Abstract

BACKGROUND AND PURPOSE

Unilateral vocal cord paralysis (UVCP) occurs after iatrogenic injury or disease process and is associated with dysphonia and aspiration. Various surgical options are available for treatment of UVCP, including vocal cord medialization thyroplasty and injection laryngoplasty. These augmentative procedures improve phonation and airway protection. Our purpose was to demonstrate the CT appearance of implants used for the treatment of UVCP.

METHODS

Twelve patients treated surgically for UVCP were studied with helical CT. The vocal cords were augmented by using Silastic implants (n = 7), polytetrafluoroethylene (Gore-Tex) implants (n = 2), Teflon injections (n = 2), or fat injection (n = 1). Augmented vocal cords were characterized by size, shape, and Hounsfield units (HU). Two other patients with failed medialization thyroplasty were evaluated for the position of the extruded implant relative to the paralyzed vocal cord.

RESULTS

The 7 Silastic implants were triangular and hyperattenuated (293.4 +/- 90.4 HU). The 2 Gore-Tex implants were heterogeneous with lobulated medial margins and were hyperattenuating (320 and 414 HU). The injected materials demonstrated ovoid/masslike configurations: the 2 Teflon injections were hyperattenuated (107 and 429 HU), and the fat injection was hypoattenuated (-102 HU). Inferior displacement of the implant was demonstrated relative to the true vocal cord in 2 patients with failed Silastic thyroplasties.

CONCLUSION

CT can distinguish various types of vocal cord augmentation. Silastic implants are recognized by their characteristic triangular configuration. The Gore-Tex implants had unique heterogeneous attenuation with lobulated medial margins. Fat and Teflon injections both appear ovoid/masslike. Teflon injection should not be mistaken for tumor.

Authors+Show Affiliations

Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. vakumarmd@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16971603

Citation

Kumar, V A., et al. "CT Assessment of Vocal Cord Medialization." AJNR. American Journal of Neuroradiology, vol. 27, no. 8, 2006, pp. 1643-6.
Kumar VA, Lewin JS, Ginsberg LE. CT assessment of vocal cord medialization. AJNR Am J Neuroradiol. 2006;27(8):1643-6.
Kumar, V. A., Lewin, J. S., & Ginsberg, L. E. (2006). CT assessment of vocal cord medialization. AJNR. American Journal of Neuroradiology, 27(8), 1643-6.
Kumar VA, Lewin JS, Ginsberg LE. CT Assessment of Vocal Cord Medialization. AJNR Am J Neuroradiol. 2006;27(8):1643-6. PubMed PMID: 16971603.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CT assessment of vocal cord medialization. AU - Kumar,V A, AU - Lewin,J S, AU - Ginsberg,L E, PY - 2006/9/15/pubmed PY - 2006/11/11/medline PY - 2006/9/15/entrez SP - 1643 EP - 6 JF - AJNR. American journal of neuroradiology JO - AJNR Am J Neuroradiol VL - 27 IS - 8 N2 - BACKGROUND AND PURPOSE: Unilateral vocal cord paralysis (UVCP) occurs after iatrogenic injury or disease process and is associated with dysphonia and aspiration. Various surgical options are available for treatment of UVCP, including vocal cord medialization thyroplasty and injection laryngoplasty. These augmentative procedures improve phonation and airway protection. Our purpose was to demonstrate the CT appearance of implants used for the treatment of UVCP. METHODS: Twelve patients treated surgically for UVCP were studied with helical CT. The vocal cords were augmented by using Silastic implants (n = 7), polytetrafluoroethylene (Gore-Tex) implants (n = 2), Teflon injections (n = 2), or fat injection (n = 1). Augmented vocal cords were characterized by size, shape, and Hounsfield units (HU). Two other patients with failed medialization thyroplasty were evaluated for the position of the extruded implant relative to the paralyzed vocal cord. RESULTS: The 7 Silastic implants were triangular and hyperattenuated (293.4 +/- 90.4 HU). The 2 Gore-Tex implants were heterogeneous with lobulated medial margins and were hyperattenuating (320 and 414 HU). The injected materials demonstrated ovoid/masslike configurations: the 2 Teflon injections were hyperattenuated (107 and 429 HU), and the fat injection was hypoattenuated (-102 HU). Inferior displacement of the implant was demonstrated relative to the true vocal cord in 2 patients with failed Silastic thyroplasties. CONCLUSION: CT can distinguish various types of vocal cord augmentation. Silastic implants are recognized by their characteristic triangular configuration. The Gore-Tex implants had unique heterogeneous attenuation with lobulated medial margins. Fat and Teflon injections both appear ovoid/masslike. Teflon injection should not be mistaken for tumor. SN - 0195-6108 UR - https://www.unboundmedicine.com/medline/citation/16971603/CT_assessment_of_vocal_cord_medialization_ L2 - http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=16971603 DB - PRIME DP - Unbound Medicine ER -