Hyaluronic acid
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Hyaluronic acid Laryngeal abscess: case report
A 42-year-old woman developed laryngeal abscess following administration of hyaluronic acid for medialisation laryngoplasty. The woman, who had experienced the onset of hoarseness following thyroidectomy surgery, underwent a laryngoscopic examination. A left vocal fold paralysis was identified. Her Voice Handicap Index (VHI-10) was 32. Due to glottic insufficiency, laryngoplasty was recommended. After thyroidectomy surgery, the left vocal fold was augmented with hyaluronic acid 0.6mL injection [hyaluronic acid-dextranomer; route not stated] under general anaesthesia. Three days following injection laryngoplasty, she presented with midline neck swelling and erythema along with a mild stridor, which had developed on the postsurgical day 2 and had gradually worsened. A fiberoptic laryngoscopic examination showed hyperaemia as well as oedema of the left hemilarynx. Blood examination revealed mild leucocytosis. A CT scan confirmed the presence of a heterogeneous hypodense abscess measuring 3 × 2cm lesion, in the midline of the larynx. The woman underwent an abscess drainage out and some purulent discharge was sent for microbiological testing. She was empirically treated with ciprofloxacin and methylprednisolone at tapering doses. On day 3 following the abscess drainage, a laryngoscopic examination revealed partial regression of the oedema of the left hemilarynx. Additionally, there was a decrease in the midline neck swelling and the erythema. No growth in the culture was noted. Empirical antibiotic treatment was given for a week. On day 10 after injection laryngoplasty, her glottic closure was normal. Preoperative hoarseness and effortful voice had completely disappeared. A follow-up at the twelfth postoperative month, showed no glottic gap and no hoarseness on phonation. Her VHI-10 was 7 and no additional therapy was planned. Enver N, et al. A Very Rare Complication of Hyaluronic Acid Injection for Medialization Laryngoplasty: A Case With Laryngeal Abscess. Journal of Voice 34: 812.e5-812.e8, No. 5, Sep 2020
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Reactions 5 Dec 2020 No. 1833
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