Evidence map›Paper›PMID 42248802›Full record

ArticleThe Laryngoscope2026

Silk-Hyaluronic Acid Laryngoplasty Outcomes: An Independent Tertiary Center Experience.

Benjamin Wajsberg, Anastasia M Christ, Sarah E Benyo, Connor A Keuchel, Radhika Duggal, Richard Wu, Michael S Benninger, Rebecca C Nelson, Paul C Bryson, William S Tierney

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Benjamin WajsbergCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Anastasia M ChristCase Western Reserve University School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-6325-3417
Sarah E BenyoCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-8032-5291
Connor A KeuchelCase Western Reserve University School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Radhika DuggalCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0002-3368-5822
Richard WuCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Michael S BenningerCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0003-1908-397X
Rebecca C NelsonCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Paul C BrysonCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
William S TierneyCleveland Clinic Voice Center, Department of Otolaryngology, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0001-7371-9364

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the safety and efficacy of silk protein-hyaluronic acid (silk-HA) injection laryngoplasty for glottic insufficiency at an independent tertiary academic voice center and compare outcomes and complication rates with those of HA injection augmentation.

methodsWe retrospectively reviewed patients undergoing SilkVoice augmentation between June 2022 and August 2025 at a single institution. Outcomes included patient-reported vocal improvement, emergency department visits, hospitalizations, and operative interventions. For patients with prior HA injection, silk-HA outcomes were compared using a within-patient design.

resultsThirty-three patients underwent 44 silk-HA injections (mean age 73.4 years; 51.5% female). Outcome data were available for 29 patients (87.9%). Most procedures (95.5%) were office-based with a mean follow-up of 12.7 months. Overall, 86.2% of patients reported at least minimal vocal improvement and 79.3% reported partial to significant improvement. In a within-patient comparison of 20 patients who received both silk-HA and prior HA, median improvement scores were equivalent (p = 0.776). Compared with a historical HA cohort from the same institution (691 patients, 1146 injections), operative intervention was significantly higher in silk-HA (6.8% vs. 0.6%, p = 0.005); two cases were elective revisions for overaugmentation, and one occurred in the setting of lung cancer progression.

conclusionSilk-HA injection laryngoplasty demonstrates safety and efficacy for glottic insufficiency with voice outcomes comparable to HA and no increase in serious adverse events despite higher operative revision rates. These findings from an independent academic voice center provide external validation supporting silk-HA as a viable office-based augmentation option. LEVEL OF EVIDENCE: 3:

Indexed as

Hyaluronic AcidLaryngoplastySilkVocal Cord ParalysisAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTertiary Care CentersTreatment OutcomeHyaluronic AcidSilkinjection laryngoplastysilk–hyaluronic acidvocal fold atrophyvocal fold augmentationvocal fold paralysis

Identifiers

PMID42248802
PMCPMC13569702

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.