(712) Injection Medialization Laryngoplasty for Throat Symptoms in Patients with Presbylarynx

Introduction: Presbylarynx is a common age-related cause of glottic insufficiency and is associated with throat-related symptoms including voice changes, cough, globus, and dysphagia. While injection medialization laryngoplasty (IML) is commonly used to improve voice, its effects on other throat symptoms in older adults are less well characterized.

Methods: A retrospective observational review was performed of patients aged ≥60 years with videostroboscopic findings of presbylarynx, in the absence of other laryngeal pathology, who underwent temporary bilateral vocal fold injection augmentation between 2013 - 2021. Demographic and procedural data were collected. Patient-reported outcome measures included the Cough Severity Index (CSI), Reflux Symptom Index (RSI), Eating Assessment Tool-10 (EAT-10), and Voice Handicap Index-10 (VHI-10), obtained preprocedure and at first postprocedure follow-up. Subgroup analyses were performed for patients with abnormal baseline scores and for those presenting with subjective dysphagia.

Results: A total of 160 patients were included, with a mean age of 74.3 years. At first follow-up (mean 53.4 days), significant improvement was observed in all PROM scores for the entire cohort. 123 patients with abnormal baseline RSI (>13) and 86 patients with abnormal baseline CSI (CSI ≥ 3) scores also improved significantly, overall. Among patients reporting dysphagia at baseline (N= 87), more than half (54.0%) recorded improvement in EAT-10 scores, and approximately one quarter (24.1%) achieved normalization of EAT-10 scores ( < 3). Symptom improvement was not associated with comorbidities, injection approach, injectable material, injected volume, or follow-up interval.

Conclusions: Temporary injection medialization laryngoplasty was associated with significant short-term improvement in cough, reflux-related throat symptoms, and dysphagia in older patients with presbylarynx. Patients with abnormal baseline symptoms demonstrated the greatest benefit, supporting consideration of glottic insufficiency treatment for persistent throat-related symptoms in this population.