Device Failure During Injection Medialization Laryngoplasty.

Objectives: Injection medialization laryngoplasty is a commonly performed procedure for the management of glottic insufficiency. Among complications of this procedure is device failure, for which the literature is scarce. Our goal was to determine the prevalence of needle failure during injection laryngoplasty among members of the American Bronchoesophagological Association (ABEA).

Methods: A questionnaire was designed and subsequently sent to members of ABEA via electronic mail. Responses were analyzed using descriptive statistics.

Results: Twenty-four members (6.7%) completed the survey. Eighty three percent reported experience with needle failure; 59% of these were needle clogging, 22% needle twisting, and 19% needle tip fracture. Fifty-four percent of respondents reported needle failure during a percutaneous approach, and 48% reported using calcium hydroxyapatite during device failure. Twenty percent reported having to abort the procedure due to device failure. Twenty five percent of respondents experienced needle tip fracture that led to an airway or esophageal foreign body.

Conclusions: Needle failure during injection laryngoplasty was reported by most respondents. Most commonly this was due to clogging or twisting which was managed by replacing the needle but in 25% of cases was due to a broken tip that results in an aerodigestive tract foreign body and aborting of the procedure in most cases.