Adverse Reaction to Restylane: A Review of 63 Cases of Injection Laryngoplasty.

The aim of this study is to review the prevalence of adverse reactions to cross-linked hyaluronic acid (HA) following injection laryngoplasty and discuss possible mechanisms. A retrospective chart review of patients who underwent injection laryngoplasty using HA was conducted. Demographic data included age, gender, etiology, site of injection, and amount injected. Adverse reaction was diagnosed by the presence of inflammatory reaction at the injection site. A total of 63 patients were included, divided into 41 males and 22 females with a mean age of 51.76 years. The most common etiology was vocal cord paralysis (n = 53), followed by postcordectomy, puberphonia, and vocal fold atrophy and bowing. The average amount injected was 0.56 (0.22) mL. Three cases out of 63 patients developed an adverse reaction and presented with airway symptoms, namely, progressive shortness of breath and globus 2 to 3 days postinjection. Adverse reactions following HA injection laryngoplasty may occur with life-threatening symptoms.