Magnetic resonance imaging of micronized dermal graft in the larynx.
OBJECTIVE
This study was conducted to evaluate magnetic resonance imaging (MRI) as an objective measure of survival of micronized acellular human dermal graft (Cymetra, LifeCell Corporation) injected into the thyroarytenoid muscle for augmentation of unilateral vocal fold paralysis.


METHODS
We performed a retrospective review of MRI scans obtained in 6 patients in whom Cymetra was injected into the thyroarytenoid muscle. Gadolinium-enhanced MRI of the larynx was performed 3 days, 1 month, 8 months, 11 months, 15 months, and 21 months after injection. The survival of injected Cymetra was assessed according to information obtained from the MRI scan. Images were also obtained for 1 cm3 of reconstituted Cymetra paste.


RESULTS
The identification of Cymetra in the larynx is based on its proteinaceous content. T1-weighted images of the injected material in the true vocal fold showed hyperintense foci corresponding to injected Cymetra. Hyperintense signal was also present on the T2-weighted images. Persistence of the injected Cymetra was readily detectable by MRI for as long as 11 months.


CONCLUSIONS
Cymetra is a viable treatment option for vocal fold augmentation. The duration of survival of Cymetra (as long as 11 months) makes it a good option in cases in which longer survival of the injectable material is needed.
Moonis
Gul
G
Department of Radiology, Hospital of the University of Pennsylvania, 5 Ravdin, 3400 Spruce St, Philadelphia, PA 19104, USA.
Dyce
Orville
O
Loevner
Laurie A
LA
Mirza
Natasha
N
D000328:Adult; D003094:Collagen / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005682:Gadolinium; D006801:Humans; D007273:Injections, Intramuscular; D007821:Laryngeal Muscles; D007830:Larynx / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000188:drug therapy*
C471832:Cymetra; D003094:Collagen; D005682:Gadolinium