(0518) Functional Indications of Dermal Filler in the Head and Neck: A Systematic Review

Introduction: The use of injectable filler in cosmetic medicine and surgery is a popular means of correcting facial volume loss. The application of injectable filler has expanded to include the numerous head and neck pathologies that are managed and treated by a variety of medical and dental specialties. This study aims to identify and summarize both common and novel non-cosmetic uses of injectable fillers in treating head and neck pathologies across disciplines.

Methods: A structured search was conducted in two electronic databases: Medline (Ovid) and Embase. Studies reporting the use of injectable fillers in the context of head and neck pathologies were included. Data was organized by indication and type of filler used. Pathologies were grouped according to anatomical location: laryngeal, oropharyngeal, sinonasal, oral cavity, dermatologic, orbital, craniofacial, and other. Both established and novel uses were recorded and themes were identified and qualitatively assessed.

Results: In total, 290 studies (n = 10,316) were ultimately included. There were 35 distinct indications for use of non-cosmetic filler in the head and neck identified. Medical specialties most often reporting functional uses of filler were otolaryngology, ophthalmology, dermatology, dentistry, and plastic surgery. The most used filler material was hyaluronic acid. The most common indications for treatment were vocal fold pathologies (n = 97 studies, 4,052 patients), facial dysmorphia (n = 57 studies, 1,560 patients), temporomandibular joint disorder (n = 30 studies, 1,760 patients), orbital pathologies (n = 20 studies, 185 patients), velopharyngeal insufficiency (n = 18 studies, 1,062 patients), and scar revisions (n = 12,655 patients). Many novel uses of filler were also identified across disciplines.

Conclusions: Non-cosmetic uses of filler in the head and neck are being performed by a number of specialists to treat a wide array of pathologies with emerging uses that are not well described in the literature. This study contributes a cross-discipline comprehensive current update of non-cosmetic and predominantly off-label uses of filler in the head and neck.