Postoperative complications after injection laryngoplasty for minor laryngeal clefts.

چکیده اصلی

OBJECTIVE: To describe the incidence, clinical presentation, and management of postoperative complications following injection laryngoplasty for minor laryngeal clefts and to assess their impact on postoperative dysphagia evolution. METHODS: A unicentric retrospective case-control study of pediatric patients who underwent injection laryngoplasty for minor laryngeal clefts (hyaluronic acid-based injectable or sodium carboxymethylcellulose) between January 2018 and October 2025 in a tertiary pediatric center was conducted. Demographics, comorbidities, intraoperative variables, postoperative dysphagia outcomes, and Penetration-Aspiration Scale scores were analyzed. Ordinal logistic regression was used to evaluate the overall dysphagia trajectory. RESULTS: Among 48 patients, 10 (20.8%) developed postoperative complications. Case and control groups were comparable in age, sex, weight percentiles, gestational age and most comorbidities. Operative duration, injected volume, and intraoperative antibiotic use were similar (all p > 0.2). Swallowing outcomes (resolution, improvement, persistence, or worsening) did not differ between groups. Ordinal logistic regression showed no association between complications and the dysphagia trajectory (Odds ratio, OR 5.1, p = 0.2). PAS severity categories were also similar (p = 0.8). Patients with hyaluronic acid appeared to have more complications (26.5%) compared to methylcellulose (7.1%), despite not reaching statistical significance. CONCLUSION: Despite a higher-than-expected complication rate, postoperative inflammatory or infectious complications were not linked to worse swallowing function or higher PAS scores. These findings inform risk-benefit discussions and support informed shared decision-making with families regarding minor cleft treatment options.

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