Tadashi Fujioka

Voice prognosis after liquid and solid silicone injection

A study was undertaken to determine the voice prognosis in 51 of the 408 patients with unilateral recurrent laryngeal nerve paralysis who had visited the Department of Ear, Nose and Throat at Keio University between 1977 and 1984. The 51 patients were divided into three groups: 18 patients without silicone injection, 15 with a silicone liquid implant, and 18 with a silicone solid implant. Data are provided to show that (1) both types of silicone implant are tolerated by the body and effective in improving voice and that (2) the liquid implant is ultimately absorbed and therefore useful for temporary voice improvement in patients in whom the prognosis for vocal fold paralysis is not known, whereas the solid implant is not absorbed and is therefore effective in the long term when recovery can be ruled out.

Response of the human larynx to silicone.

This report is concerned with tissue reaction to silicone and, in particular, long-term foreign body reaction. A histopathologic study was done on the larynx of a patient who had been injected 12 years before in the right vocal fold with room temperature vulcanizing silicone. The examination revealed particles of silicone encapsulated by thin fibrous tissue. There were few giant cells of the foreign body type and little cell infiltration. In addition, a questionnaire was returned by 54 of 90 patients who had vocal fold injected with less than 1.5 mL of either silicone fluid or room temperature vulcanizing silicone in the vocal fold from 1977 to 1984. Of these 54 patients, there was no occurrence of laryngeal disease, carcinoma, and/or connective tissue disease after the silicone injection. These findings attest to the safety of silicone in the small amounts used to treat vocal cord paralysis.