Zain H Rizvi
University of California - Los Angeles
Objective: Calcium hydroxyapatite has been demonstrated as a safe and effective injection material for vocal fold medializaiton; however, the long-term status of patients undergoing this procedure is not well described. We sought to determine treatment duration and patient-centered clinical outcomes following calcium hydroxyapatite injection laryngoplasty.Method: In-office injection laryngoplasty patients were identified by CPT code (31570), between the dates of 1/1/2013 and 1/1/2016 and clinical data recorded.Results: Sixty patients underwent calcium hydroxyapatite injection laryn-goplasty during the time period studied, most commonly for complete uni-lateral vocal cord paralysis (49.2%) followed by unilateral vocal fold paresis (30.5%), with 77% of patients receiving a single injection. Thirty-three pa-tients returned for follow up (55.0%) with a mean follow up duration of 336 days (median=256). Thirteen of the 33 (39.3%) long-term follow up pa-tients underwent at least one additional in-office injection laryngoplasty due to reported persistent (46.2%) or return of dysphonia (53.8%), with a median time interval of 103 days to second injection. 11.7% of the long-term follow up patients elected for open surgical management. While vol-ume of injection (p<.005) and age (p<.001) was associated with time to repeat injection, number of injections (p=0.450) was not predictive of ad-vancement to surgical intervention.Conclusion: In-office injection laryngoplasty with calcium hydroxyapatite offers excellent and durable patient-centered outcomes when long-term medialization is desired. The majority of patients sought only a single pro-cedure, and only 7% of patients progressed to surgical medialization.