Ablation of Teflon Granulomas in the Canine Larynx with the Free-Electron Laser

This study develops a canine model for the treatment of laryngeal Teflon granulomas and demonstrates endoscopic ablation using the free-electron laser (FEL) set at a wavelength of 8.5 μm. Laryngeal Teflon granulomas may cause dysphonia and airway obstruction, and they are difficult to remove. The infrared absorption spectrum of Teflon reveals a strong absorption peak centered at 8.5 μm. In this study, 12 dogs had the right vocal cord injected with Teflon paste. Two months later, Teflon granuloma formation was confirmed histologically. Laser incisions into the granulomas were performed at 3 different wavelengths: 7.4 μm (FEL), 8.5 μm (FEL), and 10.6 μm (carbon dioxide laser). Histopathologic analysis was performed at 1 week and 6 weeks after the laser incisions. The FEL at the 8.5-μm wavelength was found to optimally ablate the Teflon granulomas, but the granulomas persisted in the specimens treated with 7.4 μm (FEL) and 10.6 μm (carbon dioxide laser).

[1]  H. Dedo,et al.  Intracordal Injection of Teflon® in the Treatment of 135 Patients with Dysphonia , 1973, The Annals of otology, rhinology, and laryngology.

[2]  R. Lewy.  Teflon Injection of the Vocal Cord: Complications, Errors, and Precautions , 1983, The Annals of otology, rhinology, and laryngology.

[3]  G. Arnold.  XXX Alleviation of Aphonia or Dysphonia , 1963 .

[4]  D. Bless,et al.  Clinical Experience with Injectable Collagen for Vocal Fold Augmentation , 1986 .

[5]  B. Mccabe,et al.  Phonosurgery: Indications and Pitfalls , 1989, The Annals of otology, rhinology, and laryngology.

[6]  G. Arnold,et al.  Vocal Rehabilitation of Paralytic Dysphonia: IX. Technique of Intracordal Injection , 1962 .

[7]  S. Shapshay,et al.  Carbon dioxide laser in removal of polytef paste. , 1987, Archives of otolaryngology--head & neck surgery.

[8]  G. M. Hale,et al.  Optical Constants of Water in the 200-nm to 200-microm Wavelength Region. , 1973, Applied optics.

[9]  J. Netterville,et al.  Difficulties in Endoscopic Removal of Teflon Granulomas of the Vocal Fold , 1993, The Annals of otology, rhinology, and laryngology.

[10]  H. Dedo,et al.  Histologic evaluation of Teflon granulomas of human vocal cords. A light and electron microscopic study. , 1982, Acta oto-laryngologica.

[11]  A. Perry,et al.  Cordectomy: a solution to Teflon granuloma of the vocal fold , 1995, The Journal of Laryngology & Otology.

[12]  N. Isshiki,et al.  Thyroplasty as a new phonosurgical technique. , 1974, Acta oto-laryngologica.

[13]  H. Dedo,et al.  Surgical correction of the convex vocal cord after teflon injection , 1980, The Laryngoscope.

[14]  W. Montgomery.  Laryngeal Paralysis Teflon® Injection , 1979, The Annals of otology, rhinology, and laryngology.

[15]  J. Koufman.  Laryngoplasty for vocal cord medialization: An Alternative To Teflon® , 1986 .

[16]  J. Kasperbauer,et al.  Teflon Granulomas and Overinjection of Teflon: A Therapeutic Challenge for the Otorhinolaryngologist , 1993, The Annals of otology, rhinology, and laryngology.

[17]  D. Bless,et al.  Teflon Vocal Fold Augmentation: Failures and Management in 28 Cases , 1993, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[18]  H. Dedo.  Injection and Removal of Teflon for Unilateral Vocal Cord Paralysis , 1992, The Annals of otology, rhinology, and laryngology.

[19]  T. Mccaffrey,et al.  Migration of Teflon after Vocal Cord Injection , 1987, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[20]  G. Arnold,et al.  Intracordal polytef (Teflon) injection. Histologic study of three further cases. , 1970, Archives of otolaryngology.

[21]  Charles J. Pouchert.  The Aldrich library of infrared spectra , 1970 .

[22]  G. Arnold.  Further experiences with intrachordal teflon injection , 1964, Transactions of the American Laryngological, Rhinological and Otological Society, Inc.

[23]  G. L. Bryant,et al.  Ablation of Teflon Granuloma with the Free-Electron Laser Emitting in the Eight- to Nine-Micron Range , 1998, The Annals of otology, rhinology, and laryngology.

[24]  L. Reinisch.  Laser physics and tissue interactions. , 1996, Otolaryngologic clinics of North America.

[25]  J. Toomey,et al.  The histological response to intracordal injection of teflon paste. , 1967, The Laryngoscope.

[26]  H. Roels,et al.  Laryngeal tissue responses to Teflon. , 1967, Archives of otolaryngology.

[27]  H. Hoffman,et al.  Long-Term Result of Vocal Cord Augmentation with Autogenous Fat , 1995, Annals of Otology, Rhinology and Laryngology.

[28]  John M. Kokosa.  Hazardous chemicals produced by laser materials processing , 1992 .

[29]  R. Hillman,et al.  Teflon Granuloma of the Larynx: Etiology, Pathophysiology, and Management , 1995, The Annals of otology, rhinology, and laryngology.

[30]  J. Netterville,et al.  Silastic Medialization and Arytenoid Adduction: The Vanderbilt Experience , 1993, The Annals of otology, rhinology, and laryngology.

[31]  C. W. Cummings,et al.  Comparison of Soft Tissue Response in Rabbits following Laryngeal Implantation with Hydroxylapatite, Silicone Rubber, and Teflon , 1997, The Annals of otology, rhinology, and laryngology.

[32]  D. Svoboda,et al.  Studies of the larynx after teflon injection. , 1966, Archives of otolaryngology.

[33]  G. Arnold.  Alleviation of aphonia through intracordal injection of teflon paste , 1963 .

[34]  R. Lewy.  Responses of laryngeal tissue to granular teflon in situ. , 1966, Archives of otolaryngology.