Safety Profile in Hyaluronic Acid‐Based Vocal Fold Injection Augmentation

ABSTRACT Objective The study's objective is to assess the safety profile and complication rates of hyaluronic acid‐based vocal fold injection augmentation (VFIA), specifically evaluating inflammatory reactions, injection volume, and COVID‐19 vaccination status. Methods A retrospective cohort study was conducted of 299 VFIA procedures performed using Restylane‐L at a single academic institution. Medical charts were reviewed to collect patient demographics, injection details (approach, location, and volume), videolaryngostroboscopy exams, and post‐injection outcomes, including complication rates and nature of inflammatory reactions. Results The overall complication rate was 4.0% (12/299), with inflammatory complications comprising 2.34% (7/299) of cases. Inflammatory symptoms developed a mean of 4.3 days after injection (median: 3 days; range: 12 h–10 days) and resolved in all cases with corticosteroid therapy. A statistically significant difference in injection volume was noted among groups ( p = 0.037), although post hoc comparisons did not demonstrate significance. COVID‐19 vaccination status was not associated with complication rates ( p = 0.84). Conclusions VFIA using HA‐based material demonstrates a low rate of complications, and all inflammatory reactions resolved with medical management. Injection volume may play a role in complication risk, but further multi‐site studies are needed. No association between COVID‐19 vaccination and adverse outcomes was identified. Level of Evidence 3