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Time to Injection Laryngoplasty: A Quality Improvement Analysis.

Jennifer A Silver1, Carolina Peralta1, Alicia Belaiche2

  • 1Department of Otolaryngology - Head and Neck Surgery, McGill University, Montréal, Canada.

Journal of Voice : Official Journal of the Voice Foundation
|April 12, 2025
PubMed
Summary
This summary is machine-generated.

Early vocal fold augmentation injection laryngoplasty with hyaluronic acid is effective for glottic insufficiency. Most patients receive timely treatment, especially those with aspiration or dysphagia, with antithrombotic therapy being a key delay factor.

Keywords:
Injection laryngoplasty—Vocal fold augmentation—In-office procedure—Hyaluronic acid

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Area of Science:

  • Otolaryngology
  • Speech and Hearing Science
  • Medical Technology

Background:

  • Vocal fold (VF) augmentation injection laryngoplasty using hyaluronic acid offers rapid, office-based treatment for glottic insufficiency.
  • Early intervention (within 3 months) can prevent hospital readmissions, aspiration pneumonia, and reduce the need for permanent surgical procedures like Type 1 thyroplasty.

Purpose of the Study:

  • To determine the average time to first injection laryngoplasty for glottic insufficiency.
  • To characterize patient demographics undergoing VF medialization.
  • To identify factors causing treatment delays.

Main Methods:

  • A retrospective quality improvement assessment analyzed patients receiving initial hyaluronic acid injection for glottic insufficiency between April 2021 and March 2024.
  • Data on patient demographics and reasons for delay (e.g., antithrombotic therapy, voice therapy, anxiety, infections) were extracted from clinical records.

Main Results:

  • 139 patients underwent VF augmentation; 48.9% female, 51.1% male, average age 66.2 years.
  • Vocal cord paralysis (71.9%) was the most common indication, followed by VF atrophy (22.3%).
  • Mean time to injection was 21.7 days; patients with aspiration/dysphagia were injected within 9.8 days. Patients without delaying factors received injections within 1.44 days.

Conclusions:

  • The institution achieves early injection laryngoplasty in most patients, often within two days when no delaying factors are present.
  • Antithrombotic therapy was identified as the primary factor delaying treatment.
  • Prompt injection is crucial for managing glottic insufficiency and associated complications.