Montgomery® implant extrusion after type I thyroplasty. A CARE case report.

GOAL: To document the first case of Montgomery® implant extrusion after type I thyroplasty for unilateral laryngeal nerve paralysis in adults.

CASE: Three years after onset of right idiopathic unilateral laryngeal nerve paralysis resulting in severe dysphonia not improved by speech therapy, a 45-year-old Caucasian woman consulted to improve her voice. Maximum phonation time (MPT) was 5seconds. Voice Handicap Index (VHI) was 64. Type I thyroplasty with n°10 Montgomery® implant was performed without difficulties. Immediate postoperative course was uneventful. One month after thyroplasty, the patient considered her voice normal, with 8sec MPT and VHI of 23. At 4 months, there was implant extrusion through the cervical skin, with 9sec MPT and VHI of 18.

CONCLUSION

When performing type I thyroplasty with Montgomery® implant, the otorhinolaryngologist must not only take care to position the implant properly within the thyroid lamina but also ensure that the inner flanges of the implant are well deployed, to achieve proper retention.