Injection laryngoplasty in the outpatient clinic under local anaesthetic: a case series of sixty-eight patients

Objectives: We aimed to assess self-report and perceptual voice outcomes in patients undergoing local anaesthetic injection laryngoplasty in our outpatient clinic. Design: Prospective case series. Setting: Department of Otolaryngology-Head and Neck Surgery, Freeman Hospital, Newcastle-upon-Tyne, UK. Participants: Sixty-eight patients underwent local anaesthetic injection laryngoplasty in the outpatient clinic over the 2-year study period. Main outcome measure: Voice Performance Questionnaire (patient-rated), and perceptual voice analysis (observer-rated) Grade, Roughness, Breathiness, Aesthenia and Strain scores were recorded before and 2 weeks after injection laryngoplasty. Results: Fifty-seven patients had sufficient pre- and post-procedure data to be included in the analysis. These included 32 men and 25 women, age range 26-97 years. Of the remaining patients, they were excluded due to failed procedure (n = 3), too unwell to proceed (n = 1), died before follow-up was complete (n = 3) and incomplete data (n = 4). The median Voice Performance Questionnaire score improved from 42 to 21; (P < 0.0001). Significant improvements were seen in all parameters of Grade, Roughness, Breathiness, Aesthenia, Strain. Conclusion: Injection laryngoplasty under local anaesthetic in the outpatient clinic generates improvements in subjective and perceptual voice outcomes similar to those obtained in the operating room under general anaesthetic or sedation. Complication rates between these procedures were also comparable. Injection laryngoplasty under local anaesthetic is timely, cost-effective and obviates need for general anaesthesia in patients, many of whom have comorbidities and diminished life expectancy.