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Published on: January 13, 2017
Comparison of outcomes and complications between awake and asleep injection laryngoplasty: a case-control study
Clyde C Mathison1, Craig R Villari, Adam M Klein
1Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia 30308, USA.
Objectives/Hypothesis:
To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty (IL) under local versus general anesthesia.
Study Design:
Retrospective case-control review
Methods:
Charts of 141 consecutive patients undergoing IL were reviewed. Subjects who underwent IL with local anesthesia were grouped as experimental cases. Subjects who underwent IL with general anesthesia were grouped as controls. The voice-related quality of life (VRQOL) measure was employed to determine outcomes before and after IL. All undesirable events resulting from an IL were recorded as complications.
Results:
One hundred sixty-six ILs were performed in 141 patients (83 males, mean age = 58.9 years). Unilateral vocal fold immobility was diagnosed in 60.9%. One hundred five (63.3%) ILs were performed under local anesthesia, and 61 were performed under general anesthesia. Pre- and postinjection VRQOL data was available for 78 ILs (50 cases, 28 controls). Average VRQOL in the awake patient improved by 25.05 points, whereas average VRQOL in the asleep patient improved by 20.81 points (P = .42). There were 24 complications (14.5% of all injections), which included 19.1% of cases and 6.6% of controls (odds ratio = 2.9). Six ILs had to be aborted. All complications were minor and self-limited.
Conclusions:
Both awake and asleep IL offer comparable VRQOL results. Although having the benefit of avoiding general anesthesia, IL in the awake patient has a slightly higher complication rate.
