Postoperative complications after injection laryngoplasty for minor laryngeal clefts

To describe the incidence, clinical presentation, and management of postoperative complications following injection laryngoplasty for minor laryngeal clefts and to assess their impact on postoperative dysphagia evolution.

A unicentric retrospective case-control study of pediatric patients who underwent injection laryngoplasty for minor laryngeal clefts (hyaluronic acid-based injectable or sodium carboxymethylcellulose) between January 2018 and October 2025 in a tertiary pediatric center was conducted. Demographics, comorbidities, intraoperative variables, postoperative dysphagia outcomes, and Penetration-Aspiration Scale scores were analyzed. Ordinal logistic regression was used to evaluate the overall dysphagia trajectory.

Among 48 patients, 10 (20.8%) developed postoperative complications. Case and control groups were comparable in age, sex, weight percentiles, gestational age and most comorbidities. Operative duration, injected volume, and intraoperative antibiotic use were similar (all p > 0.2). Swallowing outcomes (resolution, improvement, persistence, or worsening) did not differ between groups. Ordinal logistic regression showed no association between complications and the dysphagia trajectory (Odds ratio, OR 5.1, p = 0.2). PAS severity categories were also similar (p = 0.8). Patients with hyaluronic acid appeared to have more complications (26.5%) compared to methylcellulose (7.1%), despite not reaching statistical significance.

Despite a higher-than-expected complication rate, postoperative inflammatory or infectious complications were not linked to worse swallowing function or higher PAS scores. These findings inform risk-benefit discussions and support informed shared decision-making with families regarding minor cleft treatment options.