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Injection laryngoplasty is a simple and noninvasive method for treating unilateral vocal cord paralysis. Lately hyaluronic acid is widely used as injection material, because it is spontaneously resolved after few months and can be injected superficially compared to other materials. However, if hyaluronic acid is injected in the superficial layer of lamina propria (Reinke’s space), it can cause inflammation or granuloma, interrupt the vibration of the vocal cord and worsen the quality of voice. We here present a case of granuloma that occurred as a complication of injection laryngoplasty, where simple surgical method was employed to improve voice quality. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:782-6