Recurrent Inflammatory Reaction to Laryngeal Hyaluronic Acid Injection

Vocal fold injection augmentation with hyaluronic acid (HA) fillers is a common treatment for glottic insufficiency. While generally well-tolerated, rare inflammatory reactions can occur in 3% to 5% of patients. All reported reactions resolved after corticosteroid treatment, and no cases of recurrent inflammatory reaction with airway obstruction following steroid treatment have been reported. This case report describes a unique case of recurrent inflammatory reactions following laryngeal HA injection and management with hyaluronidase injection to prevent further reactions. A retrospective review was conducted of this patient's medical record. We present the case of a 42-year-old female with left vocal fold immobility who experienced recurrent inflammatory reactions and airway symptoms following laryngeal HA injection despite corticosteroid treatment. Recurrent inflammatory reaction following corticosteroid treatment of an initial inflammatory reaction has not been reported. This patient was managed with hyaluronidase injection to dissolve residual HA, which successfully prevented further reactions. This case highlights the potential for recurrent inflammatory reactions following HA injection despite corticosteroid treatment and describes the novel role of hyaluronidase in managing such complications.