Higher risk of superficial injection during injection laryngoplasty in women

Abstract

Purpose To review our clinical experience with percutaneous injection laryngoplasty at a single institution over a three-year period, and to specifically assess the rate of unintentional injection into the superficial lamina propria (SLP) and compare with results found in the literature. Materials and Methods Medical records were retrospectively reviewed to identify patients who underwent office-based injection laryngoplasty (OBIL) over a three-year period. Video documentation and the written notes of the procedures were reviewed to determine the rate of inadvertent placement of injectate into the SLP. A literature review was performed to identify other reports of this complication and contributing factors. Results 113 consecutive patients were identified who underwent OBIL in the study period. Of these, 100 patients had adequate records and follow-up available for this review. All patients underwent injection augmentation with bovine collagen using a percutaneous trans-membrane or trans-cartilaginous technique. 96 had improvement in their vocal quality and/or effort. Four patients, who were all women, had unintentional injection into the SLP with resultant no change in voice or worsened voice. All superficially placed injectates were managed conservatively. Conclusions Injection into the SLP is a well-recognized possible complication of OBIL. Our results suggest that this complication occurs more often in women than in men, perhaps due to differing laryngeal anatomy and size.

Novel Anatomic Characteristics of the Laryngeal Framework

“…3,4,12 Higher rates of complications were reported among women and are attributed to the anatomic sex differences. 3,4 The CT evaluation of the larynx, as performed in the current study, is easy to obtain and provides the surgeon with exact dimensions of the laryngeal skeleton. These preoperative measurements may help expose the large variability among different patients, as clearly shown in our results ( Figure 3 ), and help to reduce surgical failures from purely anatomic variability.…”

“…However, dreaded complications do occur, such as superficial injection into the superficial lamina propria during medialization and extrusion of the graft after type I thyroplasty. 3,4,12 Higher rates of complications were reported among women and are attributed to the anatomic sex differences. 3,4 The CT evaluation of the larynx, as performed in the current study, is easy to obtain and provides the surgeon with exact dimensions of the laryngeal skeleton.…”

Glottis injection to improve voice function

“…Sitzung nachinjiziert werden. Eine zu oberflächliche Injektion führt zu schlechten Stimmergebnissen [20]. Allergische Reaktionen auf das Injektionsmaterial oder eine Infektion der Injektionsstelle sind sehr selten.…”

Injection Laryngoplasty: Techniques and Choices of Fillers

“…For instance, subepithelial injection of a material such as calcium hydroxylapatite will result in inflammation and stiffness, which may be permanent [20]. It is interesting to note that females are at a higher risk of having a superficial injection secondary to their smaller larynx [21]. This places an emphasis on injection accuracy.…”