Semaglutide-induced rapid weight loss linked to vocal fold atrophy and glottic insufficiency, necessitating revision thyroplasty.

Glottic insufficiency and vocal fold atrophy are common causes of dysphonia, often linked to aging or neurological conditions. While medialization thyroplasty effectively restores voice quality by repositioning the vocal fold, significant body changes can alter its efficacy. Rapid weight loss, particularly with GLP-1 agonists like semaglutide, can lead to systemic tissue volume reduction, potentially impacting laryngeal structures and the functional outcome of prior vocal fold surgeries. This case highlights a previously under-recognized complication.

A 74-year-old female presented with new onset voice deterioration 9 years after successful bilateral medialization thyroplasty. Her symptoms coincided with a 25-pound weight loss while taking semaglutide. Evaluation included laryngeal examination, which revealed marked vocal fold atrophy and glottic insufficiency. She subsequently underwent successful revision thyroplasty surgery to address the functional voice quality changes.

The patient, previously stable for 9 years post-thyroplasty, developed significant voice deterioration. This decline was directly associated with a 25-pound weight loss attributed to semaglutide use. Clinical evaluation confirmed marked vocal fold atrophy and subsequent glottic insufficiency, indicating a structural change in the larynx. The revision surgery restored her voice quality, demonstrating a direct link between the systemic effects of rapid weight loss and laryngeal function.