Medialization Laryngoplasty with Gore-Tex (Expanded Polytetrafluoroethylene)

2006 ◽  
pp. 169-175 ◽  
Author(s):  
Timothy M. McCulloch ◽  
Henry T. Hoffman
Keyword(s):  
Expanded Polytetrafluoroethylene ◽  
Medialization Laryngoplasty

Medialization Laryngoplasty with Expanded Polytetrafluoroethylene

1998 ◽  
Vol 107 (5) ◽  
pp. 427-432 ◽  
Author(s):  
Timothy M. McCulloch ◽  
Henry T. Hoffman
Keyword(s):  
Vocal Fold ◽  
Assessment Tool ◽  
Surgical Techniques ◽  
Expanded Polytetrafluoroethylene ◽  
Median Position ◽  
History Of ◽  
The Mean ◽  
The Voice ◽  
Medialization Laryngoplasty ◽  
Special Instrumentation

Symptomatic unilateral laryngeal paralysis may be treated successfully by a wide variety of surgical techniques. These techniques share the concept that stabilization of the paralyzed vocal fold in a median position will improve glottic function. Medialization laryngoplasty with expanded polytetrafluoroethylene (ePTFE) incorporates the general principles of established medialization procedures, yet is unique in its simplicity. The technique does not require special instrumentation, employs incremental adjustment of vocal fold position, and utilizes an implantable material with a long history of patient safety. We describe this new technique and report on the outcome of our first 16 patients treated. No surgical or implant-related complications have occurred. Voice results were measured from preoperative and postoperative video and voice recordings by four independent observers using a standardized assessment tool. Voice grade and breathiness were evaluated on a four-point scale (0 = normal and 3 = abnormal, extreme). The mean overall grade improved from 2.3 ± 0.6 to 1.1 ± 0.6, and breathiness from 2.0 ± 0.8 to 0.4 ± 0.4. The technique is simple, the implant material has been in clinical use for decades, and the voice results are good to excellent.

Use of polyethylene terephthalate and expanded-polytetrafluoroethylene in medialization laryngoplasty

2003 ◽  
Vol 117 (4) ◽  
pp. 294-297 ◽  
Author(s):  
Gürkan Keskin ◽  
Zerrin Boyaci ◽  
Emre Ustundag ◽  
Ahmet Kaur ◽  
Ahmet Almaç
Keyword(s):  
Foreign Body ◽  
Polyethylene Terephthalate ◽  
Giant Cells ◽  
Tissue Reaction ◽  
Foreign Body Giant Cell ◽  
Expanded Polytetrafluoroethylene ◽  
Vocal Fold Augmentation ◽  
Foreign Body Giant Cells ◽  
Local Host ◽  
Medialization Laryngoplasty

Various materials have been used up to the present time in vocal fold augmentation. Although silicon has been the most frequently employed, the surgical difficulties encountered in shaping, positioning and placing this material have led to a search for a more easily applicable material. In our study, we investigated the local tissue reaction to implants in the laryngeal skeleton of 10 New Zealand rabbits in which we performed medialization laryngoplasty employing polyethylene terephthalate (PETP = Dacron®) and expanded polytetrafluoroethylene (e-PTFE = Gore-Tex®). When the local host tissue reaction to PETP and e-PTFE were compared, PETP was found to cause significant foreign body giant cell and histiocyte infiltration localized around fibres of the implant. The greater irregularity of the fibrous capsule formed in response to PETP and the density of foreign body giant cells around the PETP fibres suggested that resorption of the implant with time would decrease the degree of medialization.

scholarly journals Clinical, Radiographic, and Histomorphometric Evaluation of a Vertical Ridge Augmentation Procedure Using a Titanium-Reinforced Microporous Expanded Polytetrafluoroethylene Emrane: A Prospective Case Series with 1-Year Follow-Up

Materials ◽  
2021 ◽  
Vol 14 (14) ◽  
pp. 3828
Author(s):  
Jung-Gu Ji ◽  
Jung-A Yu ◽  
Seong-Ho Choi ◽  
Dong-Woon Lee
Keyword(s):  
Case Series ◽  
Graft Material ◽  
Ridge Augmentation ◽  
Expanded Polytetrafluoroethylene ◽  
Implant Placement ◽  
Significant Difference ◽  
Staged Approach ◽  
Height Change ◽  
Prospective Case Series ◽  
Augmentation Procedure

Vertical ridge augmentation for long-term implant stability is difficult in severely resorbed areas. We examined the clinical, radiological, and histological outcomes of guided-bone regeneration using novel titanium-reinforced microporous expanded polytetrafluoroethylene (MP-ePTFE) membranes. Eighteen patients who underwent implant placement using a staged approach were enrolled (period: 2018–2019). Vertical ridge augmentation was performed in areas with vertical bone defects ≥ 4 mm. Twenty-six implant fixtures were placed in 14 patients. At implant placement six fixtures had relatively low stability. On cone-beam computed tomography, the average vertical changes were 4.2 ± 1.9 (buccal), 5.9 ± 2.7 (central), and 4.4 ± 2.8 mm (lingual) at six months after vertical ridge augmentation. Histomorphometric analyses revealed that the average proportions of new bone, residual bone substitute material, and soft tissue were 34.91 ± 11.61%, 7.16 ± 2.74%, and 57.93 ± 11.09%, respectively. Stable marginal bone levels were observed at 1-year post-loading. The residual bone graft material area was significantly lower in the exposed group (p = 0.003). There was no significant difference in the vertical height change in the buccal side between immediately after the augmentation procedure and the implant placement reentry time (p = 0.371). However, all implants functioned well regardless of the exposure during the observation period. Thus, vertical ridge augmentation around implants using titanium-reinforced MP-ePTFE membranes can be successful.

Omniflow II biosynthetic grafts versus expanded polytetrafluoroethylene grafts for infrainguinal bypass surgery. A single-center retrospective analysis

Vascular ◽  
2021 ◽  
pp. 170853812110298
Author(s):  
Bart CT van de Laar ◽  
Hugo C van Heusden ◽  
Pieternel CM Pasker-de Jong ◽  
Vincent van Weel
Keyword(s):  
Limb Salvage ◽  
Infection Rate ◽  
Bypass Surgery ◽  
Primary Patency ◽  
Knee Surgery ◽  
Secondary Patency ◽  
Single Center ◽  
Expanded Polytetrafluoroethylene ◽  
Infrainguinal Bypass ◽  
Omniflow Ii

Introduction: The aim of this study is to evaluate the outcome of Omniflow II biosynthetic vascular grafts as compared to synthetic expanded polytetrafluoroethylene (ePTFE) grafts in infrainguinal bypass surgery. Methods: A single-center, retrospective, observational study was performed reviewing patients with critical limb ischemia who underwent infrainguinal bypass surgery between 2014 and 2018. Patients characteristics, graft characteristics, and treatment outcomes were collected. Patency rates were compared using Kaplan–Meier estimates. Results: Sixty bypasses were performed in 57 patients. For above-knee surgery, six were Omniflow and 13 were synthetic. For below-knee surgery, 19 were Omniflow and 22 were synthetic. Patient characteristics between groups were similar. However, American Society of Anesthesiologists (ASA) classification scores were higher in the Omniflow group as compared to ePTFE (88% was ASA 3 or higher versus 60%; p = 0.018). Furthermore, wound, ischemia, and foot infection (WIfI) composite scores were higher in the Omniflow group ( p = 0.0001). There was a trend toward more active infection at time of surgery in the Omniflow group (40 vs 22.9%, p = 0.15). At 1 year, primary patency rates were 60.0% versus 46.9% for above-knee Omniflow versus ePTFE grafts, respectively ( p = 0.72). Secondary patency rates were 80.0% versus 82.5% ( p = 0.89), and limb salvage rates were 83.3% versus 100% ( p = 0.14). For below-knee surgery, 1- and 2-year primary patency rates in Omniflow versus ePTFE grafts were 36.0% versus 41.8% ( p = 0.60) and 36.0% versus 31.1% ( p = 0.87). Secondary patency rates were 66.8% versus 75.2% at 1 year ( p = 0.53) and 58.8% versus 48.3% ( p = 0.77) at 2 years. Below-knee limb salvage rates for Omniflow versus ePTFE after 2 years were 88.0% versus 68.3% ( p = 0.28), respectively. Aneurysmal degeneration occurred in 2/25 (8%) in the Omniflow group and 0/35 (0%) in the ePTFE group. Bypass infections occurred in 2/25 (8%) in the Omniflow group and 0/35 (0%) in the ePTFE group ( p = 0.09). Conclusion: Omniflow bypasses were more commonly implanted in patients with higher limb infection rate as confirmed with a higher adapted WIfI score. A trend toward a higher infection rate of Omniflow grafts was observed but not statistically significant. Graft infection rates were relatively low and treatable with antibiotics. No significant difference in graft performance was observed. The choice between the two studied grafts remains based on surgeon’s preference.

New insight in the biological integration of polytetrafluoroethylene from an explant used for diaphragm repair

2016 ◽  
Vol 31 (6) ◽  
pp. 844-850 ◽  
Author(s):  
Anne Schneider ◽  
Isabelle Talon ◽  
Eric Mathieu ◽  
Pierre Schaaf ◽  
François Becmeur ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Connective Tissue ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Severe Disease ◽  
Central Area ◽  
Prosthesis Failure ◽  
Expanded Polytetrafluoroethylene ◽  
Peripheral Areas ◽  
Diaphragm Replacement

Congenital diaphragmatic hernia is a severe disease requiring diaphragm replacement mostly with expanded polytetrafluoroethylene. Unfortunately, the recurrence rate is high due to prosthesis failure with significant morbidity for the child. To provide a better understanding of the integration and possible failure processes of the biomaterial implanted in humans, we conducted electron microscopical and mechanical assessments on a prosthesis explant from a child with congenital diaphragmatic hernia presenting a recurrence. Our findings show a major penetration of connective tissue into the expanded polytetrafluoroethylene on the rough side, whereas the smooth side presents few tissue colonization. This penetration is more important in the central area (area A) with large collagen bundles and layers, in comparison to the peripheral areas without prosthesis failure (area B), where few extracellular matrix is produced. The connective tissue penetrates the prosthesis in depth. In contrast, the peripheral areas with prosthesis failure (area C) show very few cells and extracellular matrix, with an oriented organization in comparison to areas A and B. Obviously, the forces applied on the implanted material modulate the cellular behavior of the newly developed tissues. Atomic force microscopic measurements of the biomaterials’ surfaces may explain some cellular behaviors according to areas with or without failure.

Medialization Laryngoplasty in the Elderly: Outcomes and Expectations

2017 ◽  
Vol 157 (4) ◽  
pp. 664-669 ◽  
Author(s):  
Andrew Jay Bowen ◽  
Tiffany L. Huang ◽  
Michael S. Benninger ◽  
Paul C. Bryson
Keyword(s):  
Elderly Patients ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Tertiary Care ◽  
Anticoagulation Therapy ◽  
Voice Handicap Index ◽  
Care Hospital ◽  
Disease Etiology ◽  
Chi Square Analysis ◽  
Medialization Laryngoplasty

Objective To describe the profile and outcomes of elderly patients undergoing medialization laryngoplasty for vocal cord paralysis. Study Design Case series with retrospective review. Setting Tertiary care hospital. Subjects and Methods Patients were included in the study if they were >65 years old at the time of medialization laryngoplasty between 2008 and 2015. Patient comorbidities, anticoagulation status, disease etiology, and physical examination findings were recorded with postoperative length of stay, complications, pre- and posttreatment voice outcomes with the Voice Handicap Index (at 6 weeks, 4 months, 8 months, and 1 year), and postprocedural interventions (revision injections, surgery, therapy). Results A total of 112 patients met the eligibility criteria. Iatrogenic injury to the recurrent laryngeal nerve (50%) was the most common etiology, followed by idiopathic (31%) causes. Sixty percent of patients were receiving long-term antiplatelet and/or anticoagulation therapy. All but 14 patients on aspirin therapy stopped their antiplatelet/anticoagulation therapy prior to surgery. Most patients were discharged on the day of surgery. Postprocedure Voice Handicap Index scores significantly improved ( P < .001) by 47%, 53%, 64%, and 57% at each of the 4 measured postprocedure dates, respectively. Two patients had major nonsurgical complications postoperatively requiring inpatient hospitalization. Chi-square analysis revealed no differences between intraoperative aspirin use, sex, or comorbidities and the incidence of complications ( P > .05). Conclusion The clinical profile and outcomes of our patients undergoing medialization laryngoplasty are comparable to those seen in younger cohorts. Medialization laryngoplasty is a safe and successful option for elderly patients with vocal cord paralysis and vocal handicap.

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