(725) Safety and Complications of Autologous Fat Laryngeal Injection Augmentation

Introduction: Autologous fat laryngeal injection augmentation is a common and widely considered safe procedure for vocal fold augmentation in the setting of glottic insufficiency. However, no systematic study has described post-procedural complications among a large patient population in detail. Therefore, our objective was to assess the complication rate and characterize complications after injection augmentation with fat.

Methods: We performed a retrospective chart review of patients who received vocal fold augmentation injections with autologous fat from 2016 to 2024 at our single tertiary care hospital. The primary outcome was post-complication major events, defined as emergency department (ED) visits, hospital admissions, operative interventions, or intubations for airway compromise. We documented symptoms of post-procedural complications, timeline of complication onset and resolution, and treatments.

Results: Among 147 patients, 164 autologous fat injections were performed. The most common indication was unilateral vocal fold paresis/paralysis (60%), and all cases were performed in the operating room on an outpatient basis. There was a total of 10 patients (6.8%) with major events, which included a total of 7 ED visits, 3 hospitalizations, 0 operative interventions, and 1 intubation for airway compromise. Complications included stridor prompting ED visits (n=3), post-procedural myocardial infarction (n=1), and complications related to the abdominal fat harvest site including wound dehiscence (n=1), hematoma (n=2), and infection (n=1). Treatments included bedside incision and drainage of the abdominal fat harvest site (n=2), antibiotics (n=5), and steroids (n=2).

Conclusions: These findings affirm the safety of autologous fat laryngeal augmentation. This study provides clinicians and patients with a better understanding of the overall risks of major complications when counseling patients preoperatively.