title: Revision laryngeal surgery for the suboptimal injection of calcium hydroxylapatite.
abstract: OBJECTIVE
  The objective of this study was to describe the management of suboptimal injection of calcium hydroxylapatite during augmentation laryngoplasty.
  
  
  METHODS
  A retrospective review was conducted at four Voice and Swallowing centers to identify patients who had a suboptimal injection of calcium hydroxylapatite during augmentation laryngoplasty.
  
  
  RESULTS
  Five patients (ages 19-75) were identified with an impaired voice secondary to a superficial injection of calcium hydroxylapatite or over-medialization of the true vocal fold. All patients underwent revision surgery with all experiencing subjective and objective improvement.
  
  
  CONCLUSIONS
  Microflap excision can lead to successful return of vibratory function after a suboptimal injection of calcium hydroxylapatite. Complete control of the initial injection is paramount to avoiding this complication.
authors.affiliation: Department of Otolaryngology, Medical College of Georgia, Augusta, GA 30912, USA.
authors.forename: Neil N
authors.initials: NN
authors.lastname: Chheda
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
authors.forename: Peter C
authors.initials: PC
authors.lastname: Belafsky
authors.forename: C Blake
authors.initials: CB
authors.lastname: Simpson
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Postma
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D017886:Durapatite / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000209:etiology / Q000601:surgery; D006801:Humans; D007267:Injections; D007821:Laryngeal Muscles / Q000601:surgery*; D007828:Laryngoscopy; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D019736:Prostheses and Implants; D012086:Reoperation; D012189:Retrospective Studies; D049489:Stroboscopy; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014827:Vocal Cords / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology* / Q000601:surgery; D055815:Young Adult
chemical_list: D017886:Durapatite