title: Clinical experience with Gore-Tex for vocal fold medialization.
abstract: OBJECTIVE
  Present clinical experience with vocal fold medialization under local anesthesia using a Gore-Tex implant. The procedure consists of placing the implant into a pocket formed by dissection of the inner perichondrium of the thyroid cartilage through a small window made in the thyroid ala.
  
  
  METHODS
  During 2 years, we used this technique preferentially in 13 of the 16 cases of vocal fold medialization (three patients underwent Teflon injection because of a contraindication to local anesthesia). Follow-up was longer than 3 months in 11 cases (mean, 13 mo).
  
  
  METHODS
  Vocal result was analyzed by the means of perceptual analysis and by the measurement of jitter factor. Glottal leakage was evaluated perceptually using videolaryngoscopy, and oral airflow was measured during the production of a vowel. In cases with preoperative aspiration, videofluoroscopy was performed.
  
  
  RESULTS
  Implantation was successful in all but one patient in whom extrusion of the implant material occurred. In the latter case, the implant was removed and the patient recuperated his preoperative voice without any other complication. In the 10 other cases, voice improvement assessed by perceptual and objective evaluation was satisfactory.
  
  
  CONCLUSIONS
  Results compare favorably with those of endoscopic techniques using Teflon or collagen and laryngeal frame surgery techniques using silicone or cartilage. We conclude that Gore-Tex implantation is a simple, reproducible, and minimally invasive procedure for management of selected cases of vocal fold unilateral paralysis in the abductory position.
authors.affiliation: Laboratoire d'Audio-Phonologie Clinique de l'Université de la Méditerranée, Fédération ORL, CHU Timone, Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Giovanni
authors.forename: J M
authors.initials: JM
authors.lastname: Vallicioni
authors.forename: R
authors.initials: R
authors.lastname: Gras
authors.forename: M
authors.initials: M
authors.lastname: Zanaret
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D019736:Prostheses and Implants; D014826:Vocal Cord Paralysis / Q000628:therapy*
chemical_list: D011138:Polytetrafluoroethylene