{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T02:08:55Z","timestamp":1783908535268,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study's objective is to assess the safety profile and complication rates of hyaluronic acid\u2010based vocal fold injection augmentation (VFIA), specifically evaluating inflammatory reactions, injection volume, and COVID\u201019 vaccination status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted of 299 VFIA procedures performed using Restylane\u2010L at a single academic institution. Medical charts were reviewed to collect patient demographics, injection details (approach, location, and volume), videolaryngostroboscopy exams, and post\u2010injection outcomes, including complication rates and nature of inflammatory reactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2009days after injection (median: 3\u2009days; range: 12\u2009h\u201310\u2009days) and resolved in all cases with corticosteroid therapy. A statistically significant difference in injection volume was noted among groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037), although post hoc comparisons did not demonstrate significance. COVID\u201019 vaccination status was not associated with complication rates (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.84).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VFIA using HA\u2010based 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\u2010site studies are needed. No association between COVID\u201019 vaccination and adverse outcomes was identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70513","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:45:24Z","timestamp":1774331124000},"page":"3541-3547","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety Profile in Hyaluronic Acid\u2010Based Vocal Fold Injection Augmentation"],"prefix":"10.1002","volume":"136","author":[{"given":"Noah","family":"Thornton","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Stepp","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Nguyenkhoa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleeza","family":"Leder Macek","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3693-4617","authenticated-orcid":false,"given":"James J.","family":"Daniero","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia School of Medicine  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010022\u201007437\u20100"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892\u20101997(97)80024\u20100"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2007.05.006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812446913"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actbio.2010.02.012"},{"issue":"5","key":"e_1_2_10_7_1","first-page":"32","article-title":"Severe Acute Local Reactions to a Hyaluronic Acid\u2013Derived Dermal Filler","volume":"3","author":"Van Dyke S.","year":"2010","journal-title":"Journal of Clinical and Aesthetic Dermatology"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26156"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.01.010"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3906\/sag-2008-5"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/3001080"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2015.00150"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.a.34704"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S316352"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.14886"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403\u2010021\u201002190\u20106"},{"issue":"9","key":"e_1_2_10_17_1","first-page":"37","article-title":"Vascular Compromise From Soft Tissue Augmentation: Experience With 12 Cases and Recommendations for Optimal Outcomes","volume":"7","author":"Beleznay K.","year":"2014","journal-title":"Journal of Clinical and Aesthetic Dermatology"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14141555"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20737"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2016.11.014"},{"key":"e_1_2_10_21_1","volume-title":"Restylane: Instructions for Use (US)","author":"Galderma Laboratories, L.P","year":"2023"}],"container-title":["The 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