Author(s)
Lara Reichert, MD, MPH
Michael Underbrink, MD, MBA
Grant Connor, MD
Affiliation(s)
University of Texas Medical Branch
Abstract:
Objectives: To demonstrate a rare case of internal silastic thyroplasty implant extrusion 10 months after thyroplasty. Methods: Case presentation Results: We present a case of a 53-year-old female with a history of right glomus vagale tumor resection necessitating sacrifice of the right vagus nerve and internal jugular vein. She had subsequent right-sided vocal cord paralysis and underwent a medialization thyroplasty with silastic block 6 months after her initial procedure. She was very happy with her voice and had no swallowing deficits. Her history was also significant for recurrent unexplained nausea and emesis. 9 months after her thyroplasty she called our office complaining of voice change after a severe bout of emesis. She noted she had vomited and coughed out a piece of plastic. She was seen in our office the next day, and brought the extruded plastic, which was confirmed to be her silastic block. Her voice was rough and breathy, and laryngoscopy showed the right vocal cord paralyzed in paramedian position with a defect along the right ventricle. A subsequent CT scan showed a small laryngocele with no evidence of abscess or infection. She is planned for a revision surgery in 3 months. Conclusions: Implant extrusion is extremely rare after type 1 thyroplasty utilizing silastic blocks. Our patient had right sided vocal cord paralysis from sacrifice of the vagus nerve during glomus vagale tumor resection. During a severe coughing and emesis episode the implant extruded and was coughed out of the body. Patients must be counseled on the real, but still very rare, risk of implant extrusion when counseled on risks of thyroplasty.