Yonsei Med J.  2017 Nov;58(6):1245-1248. 10.3349/ymj.2017.58.6.1245.

Calcium Hydroxylapatite Pulmonary Embolism after Percutaneous Injection Laryngoplasty

• Won SJ
• Woo SH

• KMID: 2418910
• DOI: http://doi.org/10.3349/ymj.2017.58.6.1245

Abstract

Injection medialization laryngoplasty is a procedure that has many advantages in treating vocal fold paralysis; however, undesired complications can occur. We experienced a case of a pulmonary embolism, suspected in a patient who had undergone an injection laryngoplasty with calcium hydroxylapatite (CaHA). The patient suffered dyspnea after undergoing the injection laryngoplasty. Chest embolism computed tomography (CT) scan revealed a new lesion of enhancing materials at the pulmonary vasculature in the right upper lobe. The CaHA embolism was suspected, and the patient was treated with warfarin for 12 months. The patient's symptom of dyspnea nearly disappeared and a follow up chest embolism CT scan revealed no signs of the previous lesion. Thus, we would like to report this rare case along with a review of the literature.

Keyword

Pulmonary embolism; laryngoplasty; injection; vocal cord paralysis; complication

MeSH Terms

Biocompatible Materials/*administration & dosage
Durapatite/*administration & dosage
Female
Humans
Injections, Intralesional
Laryngoplasty/*methods
Middle Aged
Postoperative Complications
Pulmonary Embolism/*complications/drug therapy
Tomography, X-Ray Computed
Treatment Outcome
Vocal Cord Paralysis/*surgery/*therapy
Warfarin/therapeutic use
Biocompatible Materials
Warfarin
Durapatite

Figure

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  Fig. 1 The preoperative CT scan, showing no signs of lung and heart problem. (A) Coronal view. (B) Axial view.

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  Fig. 2 An accidental injection of CaHA around the vocal fold (A), high-density lesion in the right vocal fold (B: arrow) and inferior larynx (C: arrow). CaHA, calcium hydroxylapatite.

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  Fig. 3 A chest embolism CT scan revealed a high-density lesion in the pulmonary vasculature (arrows), most predominantly in the right upper lobe, which was thought to be caused by the CaHA injection (A and B). The follow-up chest embolism CT scan did not show the embolus lesion of the right lung previously seen (C and D). CaHA, calcium hydroxylapatite.

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