Complications of collagen injection of the vocal fold: report of several unusual cases and review of the literature.
Injection laryngoplasty is one of the most frequently performed procedures in patients with voice complaints. Various biomaterials have been used to medialize vocal folds or to treat symptoms of vocal fold scar. The ideal biomaterial would be easily injected through a fine-gauge needle, well tolerated, and long lasting. Injectable collagen preparations fulfill at least two of these criteria, and collagen has been used widely for vocal fold injections.


METHODS
We present a retrospective review of two unusual complications of collagen injection and a review of the relevant literature on the complications of medical use of collagen compounds.


RESULTS
Two patients in whom collagen was injected formed firm submucosal deposits that interrupted the normal mucosal wave and produced significant dysphonia. Surgical removal of these deposits restored the mucosal wave and improved voice quality. Management of this unusual complication of human collagen injection in the vocal fold has not been reported previously. Other complications of collagen injection include hypersensitivity reactions to bovine collagen, local abscess formation at injection sites, and possibly induction of collagen vascular disease in some patients.


CONCLUSIONS
Although collagen injections of the vocal fold rarely result in complications, physicians using collagen must be familiar with the types of complications that can occur. Proper diagnosis and prompt management of complications can result in good outcomes.
Anderson
Timothy D
TD
Department of Otolaryngology-Head and Neck Surgery, Lahey Clinic, Burlington, Massachusetts, USA.
Sataloff
Robert T
RT
D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects*; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D049489:Stroboscopy; D017211:Treatment Failure; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014827:Vocal Cords / Q000601:surgery*; D014832:Voice Disorders / Q000139:chemically induced* / Q000601:surgery*
D001672:Biocompatible Materials; D003094:Collagen