Airway Foreign Body Occurring during In-Office Vocal Fold Injection

AbstractStatement of problem:The consequences of vocal fold paralysis include voice change, airway problems and difficulty swallowing. Medialisation procedures using injected material have been used for many decades, with varying outcomes, mainly secondary to lifespan, tissue reaction or migration. Newer materials have recently become clinically available which are easier to manage and supposedly less likely to elicit foreign body reaction.Method of study:Case report.Results:We report a case of foreign body reaction and possible migration of polymethylsiloxane gel (Bioplastique™), one such material, after vocal fold injection. To our knowledge, this is the second such case described.Conclusions:This case highlights the fact that the risk of foreign body reaction and migration is still present for this material, albeit low. We also highlight the fact that, although this material can cause foreign body reactions and may possibly migrate, it is removable by microlaryngoscopy via the microflap technique, with vocal improvement.

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A Study of Fat Tissue Used in Vocal Fold Injection Augmentation

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.70.190 ◽

2019 ◽

Vol 70 (2) ◽

pp. 190-190

Author(s):

E. Tamura ◽

S. Niimi ◽

S. Kanou ◽

Y. Wada ◽

M. Iida ◽

...

Keyword(s):

Vocal Fold ◽

Fat Tissue ◽

Vocal Fold Injection

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Combination of Arytenoid Adduction and Vocal Fold Injection Laryngoplasty with Calcium Phosphate Paste (BIOPEX®) for Unilateral Vocal Cord Paralysis

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.69.346 ◽

2018 ◽

Vol 69 (6) ◽

pp. 346-355

Author(s):

Akari Kimura ◽

Masayuki Tomifuji ◽

Kosuke Uno ◽

Koji Araki ◽

Akihiro Shiotani

Keyword(s):

Calcium Phosphate ◽

Vocal Cord ◽

Vocal Fold ◽

Vocal Cord Paralysis ◽

Injection Laryngoplasty ◽

Arytenoid Adduction ◽

Vocal Fold Injection ◽

Unilateral Vocal Cord Paralysis

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Vocal Fold Injection Augmentation for Post-Airway Reconstruction Dysphonia: A Case Series

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211012594 ◽

2021 ◽

pp. 000348942110125

Author(s):

Mathieu Bergeron ◽

John Paul Giliberto ◽

Meredith E. Tabangin ◽

Alessandro de Alarcon

Keyword(s):

Vocal Fold ◽

Care Center ◽

Case Series ◽

Retrospective Chart Review ◽

Pediatric Care ◽

Voice Perception ◽

Perceptual Evaluation ◽

Airway Reconstruction ◽

Vocal Fold Injection ◽

History Of

Objectives: Post airway reconstruction dysphonia (PARD) is common and has a significant effect on the quality of life of patients. Vocal fold injection augmentation (VFIA) is one treatment that can be used to improve glottic insufficiency in some patients. The goal of this study was to characterize the use and outcomes of VFIA for PARD. Methods: Retrospective chart review from January 2007 to July 2018 at a tertiary pediatric care center. Consecutive patients with PARD who underwent VFIA, who had a preoperative voice evaluation and a follow-up evaluation within 3 months after VFIA (fat, carboxymethylcellulose gel, hyaluronic acid). Results: Thirty-four patients (20 female) underwent VFIA. The mean age at the time of the injection was 13.6 years (SD 6.1). Twenty patients (58.8%) had a history of prematurity and a mean of 1.8 open airway surgeries. After injection, 29/34 patients (85.3%) noted a subjective voice improvement. The baseline Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity score decreased by a mean of 5.7 (SD = 19.6) points, P = .12. Total pediatric Voice Handicap Index (pVHI) improved by 6.0 (SD = 19.5) points, from 57.4 (SD = 20.0) to 51.4 (SD = 17.2), P = .09. Functional pVHI subscore demonstrated a significant improvement, with a decrease of 3.4 (SD = 7.3) points, P = .02. All procedures were performed as an overnight observation and no complication occurred. Conclusion: Patients with PARD represent a complex subset of patients. VFIA is a straightforward intervention that may improve voice perception. Many patients reported subjective improvement despite minimal objective measurement. Further work is warranted to elucidate the role of injection in management of PARD

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Airway Foreign Body Mimicking an Endobronchial Tumor Presenting with Pneumothorax in an Adult: A Case Report

Medicina ◽

10.3390/medicina57010050 ◽

2021 ◽

Vol 57 (1) ◽

pp. 50

Author(s):

Jun-Ho Ha ◽

Byeong-Ho Jeong

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Chest Tube ◽

Biopsy Forceps ◽

Chest Computed Tomography ◽

Contrast Enhanced ◽

Lobar Bronchus ◽

Green Pea ◽

Airway Foreign Body ◽

The Right

Foreign body (FB) aspiration occurs less frequently in adults than in children. Among the complications related to FB aspiration, pneumothorax is rarely reported in adults. Although the majority of FB aspiration cases can be diagnosed easily and accurately by using radiographs and bronchoscopy, some patients are misdiagnosed with endobronchial tumors. We describe a case of airway FB that mimicked an endobronchial tumor presenting with pneumothorax in an adult. A 77-year-old man was referred to our hospital due to pneumothorax and atelectasis of the right upper lobe caused by an endobronchial nodule. A chest tube was immediately inserted to decompress the pneumothorax. Chest computed tomography with contrast revealed an endobronchial nodule that was seen as contrast-enhanced. Flexible bronchoscopy was performed to biopsy the nodule. The bronchoscopy showed a yellow spherical nodule in the right upper lobar bronchus. Rat tooth forceps were used, because the lesion was too slippery to grasp with ellipsoid cup biopsy forceps. The whole nodule was extracted and was confirmed to be a FB, which was determined to be a green pea vegetable. After the procedure, the chest tube was removed, and the patient was discharged without any complications. This case highlights the importance of suspecting a FB as a cause of pneumothorax and presents the possibility of misdiagnosing an aspirated FB as an endobronchial tumor and selecting the appropriate instrument for removing an endobronchial FB.

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