A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience.
OBJECTIVE
To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia.


METHODS
A retrospective review was conducted of patients who underwent injection laryngoplasty performed by a single laryngologist in a tertiary Australian laryngology centre, between February 2013 and December 2014. Patient demographics, anaesthetic modality and complications were recorded. Voice Handicap Index 10 and the Grade, Breathiness, Roughness, Asthenia, Strain scale were evaluated.


RESULTS
Thirty-four laryngoplasties were performed under general anaesthesia and 41 under local anaesthesia, with mean patient ages of 59.5 and 68.8 years, respectively. Voice Handicap Index 10 scores were significantly improved post-injection (p 0.05). All aspects of the Grade, Breathiness, Roughness, Asthenia, Strain scale showed significant improvement post-injection, except asthenia. There were seven (9.3 per cent) minor complications (five in the general anaesthesia group, two in the local anaesthesia group), all managed conservatively.


CONCLUSIONS
Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended.
Otorhinolaryngology,Head and Neck Surgery,Department of Surgery,Flinders University and Flinders Medical Centre,Adelaide,Australia.
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D
Chandran
Otorhinolaryngology,Head and Neck Surgery,Department of Surgery,Flinders University and Flinders Medical Centre,Adelaide,Australia.
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C
Woods
Flinders Centre for Epidemiology and Biostatistics,School of Medicine,Flinders University,Adelaide,Australia.
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S
Ullah
Otorhinolaryngology,Head and Neck Surgery,Department of Surgery,Flinders University and Flinders Medical Centre,Adelaide,Australia.
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E
Ooi
Otorhinolaryngology,Head and Neck Surgery,Department of Surgery,Flinders University and Flinders Medical Centre,Adelaide,Australia.
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T
Athanasiadis
D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D000772:Anesthesia, Local / Q000706:statistics & numerical data*; D001315:Australia; D055154:Dysphonia / Q000601:surgery*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D007267:Injections; D058753:Laryngoplasty / Q000379:methods*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality
C502935:Perlane; D006820:Hyaluronic Acid; C445361:Restylane
Complications; Dysphonia; Laryngoplasty; Restylane; Vocal Cord Paralysis; Vocal Cords