K Number
K983525
Device Name
GORE REVOX THYROPLASTY IMPLANT
Date Cleared
1998-12-10

(63 days)

Product Code
Regulation Number
874.3620
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
For medialization thyroplasty in patients with unilateral vocal cord paralysis to improve voice quality.
Device Description
The GORE ReVox Thyroplasty Implant is composed solely of expanded polytetrafluoroethylene (ePTFE), which is extremely inert and has excellent chemical and thermal stability. The carbon-fluorine bond is one of the strongest bonds known among organic compounds. The highly electronegative fluorine atoms form a protective sheath enveloping the chain of carbon atoms. This sheath effectively shields the carbon chain from attack by nearly all chemicals and is responsible for the chemical inertness and stability of the polymer. Polytetrafluoroethylene also has excellent thermal stability and can be used at temperatures up to 250°C. The GORE ReVox Thyroplasty Implant is provided sterile in a variety of sizes specifically configured for this indication.
More Information

Not Found

Not Found

No
The device description focuses solely on the material properties and physical form of the implant, with no mention of software, algorithms, or data processing that would indicate AI/ML. The "Mentions AI, DNN, or ML" and "Description of the training set..." sections are explicitly marked as "Not Found".

Yes.
The device is used to improve voice quality in patients with unilateral vocal cord paralysis, indicating a therapeutic purpose.

No
The device is an implantable medical device used in a surgical procedure to improve voice quality in patients with vocal cord paralysis. It is a therapeutic device, not a diagnostic one. Diagnostic devices are used to identify a disease or condition.

No

The device description explicitly states the device is composed of expanded polytetrafluoroethylene (ePTFE), which is a physical material, not software.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for "medialization thyroplasty in patients with unilateral vocal cord paralysis to improve voice quality." This is a surgical procedure performed directly on the patient's vocal cord.
  • Device Description: The device is an implant made of ePTFE, designed to be surgically placed.
  • Lack of IVD Characteristics: IVD devices are used in vitro (outside the body) to examine specimens (like blood, urine, or tissue) to provide information for diagnosis, monitoring, or screening. This device does not involve the analysis of any biological specimens.

The device is a surgical implant used for a therapeutic purpose, not for diagnostic testing.

N/A

Intended Use / Indications for Use

The GORE ReVox Thyroplasty Implant is indicated for medialization thyroplasty in patients with unilateral vocal cord paralysis (UVCP) to improve voice quality.

Product codes

77 MIX

Device Description

The GORE ReVox Thyroplasty Implant is composed solely of expanded polytetrafluoroethylene (ePTFE), which is extremely inert and has excellent chemical and thermal stability. The carbon-fluorine bond is one of the strongest bonds known among organic compounds. The highly electronegative fluorine atoms form a protective sheath enveloping the chain of carbon atoms. This sheath effectively shields the carbon chain from attack by nearly all chemicals and is responsible for the chemical inertness and stability of the polymer. Polytetrafluoroethylene also has excellent thermal stability and can be used at temperatures up to 250°C.
The GORE ReVox Thyroplasty Implant is provided sterile in a variety of sizes specifically configured for this indication.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Vocal cord

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

Not Found

Key Metrics

Not Found

Predicate Device(s)

Not Found

Reference Device(s)

Boston Medical Products Montgomery® Thyroplasty Implant, Smith & Nephew VoCoM® (Vocal Cord Medialization) System, W.L. Gore & Associates, Inc. - GORE Subcutaneous Augmentation Material (S.A.M.)

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 874.3620 Ear, nose, and throat synthetic polymer material.

(a)
Identification. Ear, nose, and throat synthetic polymer material is a device material that is intended to be implanted for use as a space-occupying substance in the reconstructive surgery of the head and neck. The device is used, for example, in augmentation rhinoplasty and in tissue defect closures in the esophagus. The device is shaped and formed by the suregon to conform to the patient's needs. This generic type of device is made of material such as polyamide mesh or foil and porous polyethylene.(b)
Classification. Class II.

0

K983525

SECTION 2

DEC 1 0 1998

Premarket Notification Summary

| 1. Submitter: | W. L. Gore & Associates, Inc.
3750 West Kiltie Lane
Flagstaff, Arizona 86002
Phone: (520) 779-2771
FAX: (520) 779-1456 |
|-------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------|
| Contact: | John W. Nicholson, Regulatory Affairs
Preparation Date: October 7, 1998 |
| 2. Applicant
Device: | Trade Name: GORE ReVox Thyroplasty Implant
Common Name: Thyroplasty Implant
Classification Name: Ear, Nose and Throat Synthetic Polymer |

3. Substantially Equivalent Devices:

GORE cites the following as predicate devices to which substantial equivalence will be established:

Material

  • Boston Medical Products Montgomery® Thyroplasty Implant .
  • Smith & Nephew VoCoM® (Vocal Cord Medialization) System .
  • . W.L. Gore & Associates, Inc. - GORE Subcutaneous Augmentation Material (S.A.M.)

4. Device Description:

The GORE ReVox Thyroplasty Implant is composed solely of expanded polytetrafluoroethylene (ePTFE), which is extremely inert and has excellent chemical and thermal stability. The carbon-fluorine bond is one of the strongest bonds known among organic compounds. The highly electronegative fluorine atoms form a protective sheath enveloping the chain of carbon atoms. This sheath

1

effectively shields the carbon chain from attack by nearly all chemicals and is responsible for the chemical inertness and stability of the polymer. Polytetrafluoroethylene also has excellent thermal stability and can be used at temperatures up to 250°C.

More than 5,000,000 clinical implants of GORE-TEX® ePTFE Medical Products in vascular, cardiac, dural, facial reconstructive, dental and a broad variety of general surgery applications during the past two decades have established a substantial body of knowledge and experience relating to the biocompatibility of ePTFE. A selected bibliography is provided in Section 10.

The GORE ReVox Thyroplasty Implant is provided sterile in a variety of sizes specifically configured for this indication. The applicant device, GORE ReVox Thyroplasty Implant, and its cited predicate devices have the same intended uses and their substantial equivalence is established in Section 5.

5. Intended Use:

The GORE ReVox Thyroplasty Implant is indicated for medialization thyroplasty in patients with unilateral vocal cord paralysis (UVCP) to improve voice quality. This is the same indication as both the VoCoM® System and the Montgomery® Thyroplasty Implant.

6. Technological Characteristics:

A literature review of the recent two decades indicates that the etiology of UVCP reveals two primary causes, neoplasm and surgical trauma. GORE ReVox Thyroplasty Implant is designed to be implanted utilizing current surgical techniques and standard surgical instruments in order to minimize surgeon "retraining". Polytetrafluoroethylene has been used in laryngoplasty procedures since the 1960s, and other treatment modalities include insertion of fat grafts, hydroxylapatite, Gelfoam, blocks of Silastic® and GORE-TEX® ePTFE grafts.

2

The predicate devices fulfill their equivalent clinical functions by providing clinicians with a space-filling biomaterial, which medializes the paralyzed vocal cord. GORE-TEX® ePTFE products have been used safely and effectively as spacefilling products in facial plastic and reconstructive applications for the past decade with no known adverse reactions attributable to the product. The microstructure of the applicant product is optimized to provide for surrounding native tissue attachment, while still allowing for device removal if revision or further augmentation is required.

3

Image /page/3/Picture/16 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" around the perimeter. Inside the circle is a stylized symbol that resembles three overlapping human figures or abstract shapes.

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

DEC 1 0 1998

W.L. Gore & Associates, Inc. C/O John W. Nicholson Regulatory Affairs Associate 3750 W. Kiltie Lane P.O. Box 900 Flagstaff, AZ 86002

Re:

K983525

Gore ReVox Throplasty Implant October 7, 1998 Dated: Received: October 8, 1998 Regulatory class: II 21 CFR 874.3620/Procode: 77 MIX

Dear Mr. Nicholson:

We have reviewed your Section 510(k) notification of intent to market the device referenced above and we have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (Premarket Approval), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 895. A substantially equivalent determination assumes compliance with the Current Good Manufacturing Practice requirements, as set forth in the Quality System Regulation (QS) for Medical Devices: General regulation (21 CFR Part 820) and that, through periodic the Food and Drug Administration (FDA) will verify such assumptions. Failure to comply with the GMP regulation may result in regulatory action. In addition, FDA may publish further announcements concerning your device in the Federal Register. Please note: this response to your premarket notification submission does not affect any obligation you might have under sections 531 through 542 of the Act for devices under the Electronic Product Radiation Control provisions, or other Federal laws or regulations.

This letter will allow you to begin marketing your device as described in your 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801 and additionally 809.10 for in vitto diamostic devices), please contact the Office of Compliance at (301) 594-4613. Additionally, for questions on the promotion and advertising of your device, please contact the Office of Compliance at (301) 594-4639. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). Other general information on your responsibilities under the Act may be obtained from the Division of Small Manufacturers Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address "https://www.fda.gov/cdr/dsmaldsmamain.html".

Sincerely yours,

Lillian Yin, Ph.D.

Director, Division of Reprodu Abdominal, Ear, Nose and Thros and Radiological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Device Name:_ GORE ReVox Thyroplasty Implant

Indications For Usc:

For medialization thyroplasty in patients with unilateral vocal cord paralysis to improve voice quality.

(PLEASE DO NOT WRITE BELOW THIS LINE - CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

Harind h. hegem
(Division Sign-Off)

Division of Reproductive, Abdominal, ENT,
and Radiological Devices
510(k) Number

Prescription Use
(Per 21 CFR 801.109) ✓

OR

Over-The-Counter Use

(Optional Format 1-2-96)