Severe systemic reaction from calcium hydroxylapatite vocal fold filler

Laryngoscope. 2013 Sep;123(9):2237-9. doi: 10.1002/lary.23762. Epub 2013 Jul 2.

Abstract

We describe a severe systemic reaction that occurred following injection augmentation with calcium hydroxylapatite vocal fold filler. The reaction occurred within 30 minutes of the procedure and consisted of diffuse itching, hives, edematous face and eyelids, and voice changes indicating glottic edema. It is classified as a grade 3 systemic reaction. Consideration is given to possible etiologies and at risk patients are discussed. We recommend a postprocedure observation time of at least 30 minutes to monitor for such reactions.

Keywords: Calcium hydroxylapatite; anaphylaxis, injection augmentation, laryngoplasty, vocal fold paralysis; systemic reaction; vocal fold filler.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Anaphylaxis / chemically induced*
  • Anaphylaxis / physiopathology
  • Biocompatible Materials
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Durapatite / adverse effects*
  • Durapatite / therapeutic use
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery
  • Esophagectomy / adverse effects*
  • Esophagectomy / methods
  • Follow-Up Studies
  • Humans
  • Injections, Intralesional
  • Laryngoscopy / methods
  • Monitoring, Physiologic
  • Risk Assessment
  • Severity of Illness Index
  • Vocal Cord Paralysis / etiology
  • Vocal Cord Paralysis / therapy*

Substances

  • Biocompatible Materials
  • Durapatite