Investigating the Evolution of Complications and the Risk Factors in Microlaryngoscopic Surgery

To investigate the evolution of complications and their risk factors in microlaryngoscopic surgery (MLS) at our institution.

In this retrospective, single-institution study, we analyzed data from 1116 patients who underwent MLS at the Tokyo Voice Center between September 2019 and January 2025.

A total of 626 women and 490 men were included, with a mean age and operative time of 45.13 ± 16.29 years and 951.34 ± 633.56 seconds, respectively. Analysis of disease distribution by sex revealed significant differences in nodules/polyps, laryngeal tumors, papillomatosis, atrophy/sulcus, leukoplakia, granulomas, and spasmodic dysphonia. Analysis of variance for age and operative time across disease categories revealed significant differences. Multiple comparisons using nodule/polyp as a reference revealed significant age differences for cysts, laryngeal tumors, Reinke's edema, leukoplakia, and paralysis. Regarding operative time, significant differences were also found for cysts, laryngeal tumors, papillomatosis, cyst/vocal fold nodule complications, spasmodic dysphonia, and arytenoid dislocations. Of the 1116 patients, 524 (47.0%) experienced complications, with a total of 945 complications recorded (including duplicate responses). The incidences of sore throat, cough, tongue numbness, intraoral damage, tasting disorder, and temporomandibular joint pain were significantly lower in this study than those in our previous study. Logistic regression analysis using age, sex, operative time, and disease as independent variables revealed that sex, papillomatosis diagnosis, and operative time were significantly associated with sore throat onset.

Some complications can be reduced by efforts and consideration on the medical staff's end. However, minor and unavoidable complications should be clearly explained to the patients before MLS.