(0812) Dissonant Outcomes: Complications of Injection Laryngoplasty Performed in Clinic Versus Operating Room

Introduction: Vocal fold augmentation via injection laryngoplasty (IL) is commonly performed for glottic insufficiency with historically few adverse outcomes. Existing literature regarding complications of IL primarily addresses immediate procedural complications and adverse reactions to the injection material. This is the first study utilizing a large database comparing complications of IL performed in the clinic setting under local anesthesia (LA) versus via direct laryngoscopy under general anesthesia (GA).

Methods: Patients who underwent IL were queried on the TriNetX research platform from 2000-2023. Patients were stratified by procedure setting (clinic or operating room). The two cohorts were balanced via propensity score matching for age at index and sex. Diagnoses of new-onset dyspnea, stridor, dysphagia, odynophagia, dysphonia, and laryngeal edema were compared across the two groups from the day of procedure to 3 months post-procedure.

Results: A total of 13,348 and 6,783 patients underwent IL under GA and LA, respectively. After propensity score matching, there were 1,715 reported complications under GA (8.56 ± 8.85%) and 1,765 reported complications under LA (11.64 ± 15.03%). Patients undergoing IL under GA were more likely to experience dyspnea (OR = 1.263, p = 0.01), stridor (OR = 4.626, p < 0.001), and laryngeal edema (OR = 1.674, p < 0.001). Patients undergoing IL under LA were more likely to experience dysphagia (OR = 0.747, p < 0.001), odynophagia (OR = 0.737, p < 0.001), and dysphonia (OR = 0.48, p < 0.001).

Conclusions: IL procedures performed in the operating room were more likely to be associated with airway complications, while procedures performed in clinic were more likely to be associated with swallowing and voice complications.