Seung Won Lee1, Ki Nam Park2. 1. Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea. lsw0922@schmc.ac.kr. 2. Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.
Abstract
OBJECTIVES/HYPOTHESIS: This study assessed the long-term efficacy and recurrence rates of percutaneous steroid injections (PSIs) for benign vocal fold lesions. STUDY DESIGN: Prospective clinical study. METHODS: A prospective human clinical trial was performed from October 2008 to September 2014 at Soonchunhyang University Hospital, Bucheon, Korea. Percutaneous steroid injection was performed in 84 consecutive patients with small benign vocal fold lesions, such as vocal fold nodules, polyps, and Reinke's edema, who could not be treated with voice therapy or surgery. Patients had acoustic aerodynamic, perceptual, stroboscopic, and voice handicap index evaluations before PSI and also 3, 6, 12, and 24 months after PSI. RESULTS: Of the 84 patients, 37 (44.0%) showed complete remission; 22 (26.2%) showed partial remission; five (6%) had no response; and 20 (23.8%) developed recurrences after PSI. Most of the objective and subjective parameters that improved statistically (P < 0.05) 3 months after PSI remained stable until 24 months. For the recurrences, the average recurrence time interval after PSI was 8.5 ± 8.2 (range 3-36) months. Recurrence was associated with voice abuse after PSI and professional voice users (P < 0.05). Complications during follow-up included minimal vocal fold hematomas in 2.4% (2 of 84) and mild vocal fold atrophy in 1.2% (1 of 84). CONCLUSION: Percutaneous steroid injection is a useful alternative modality for treating benign vocal fold lesions without morbidity. However, recurrence rates were higher with voice abuse after PSI and professional voice users. LEVEL OF EVIDENCE: 4. Laryngoscope, 126:2315-2319, 2016.
OBJECTIVES/HYPOTHESIS: This study assessed the long-term efficacy and recurrence rates of percutaneous steroid injections (PSIs) for benign vocal fold lesions. STUDY DESIGN: Prospective clinical study. METHODS: A prospective human clinical trial was performed from October 2008 to September 2014 at Soonchunhyang University Hospital, Bucheon, Korea. Percutaneous steroid injection was performed in 84 consecutive patients with small benign vocal fold lesions, such as vocal fold nodules, polyps, and Reinke's edema, who could not be treated with voice therapy or surgery. Patients had acoustic aerodynamic, perceptual, stroboscopic, and voice handicap index evaluations before PSI and also 3, 6, 12, and 24 months after PSI. RESULTS: Of the 84 patients, 37 (44.0%) showed complete remission; 22 (26.2%) showed partial remission; five (6%) had no response; and 20 (23.8%) developed recurrences after PSI. Most of the objective and subjective parameters that improved statistically (P < 0.05) 3 months after PSI remained stable until 24 months. For the recurrences, the average recurrence time interval after PSI was 8.5 ± 8.2 (range 3-36) months. Recurrence was associated with voice abuse after PSI and professional voice users (P < 0.05). Complications during follow-up included minimal vocal fold hematomas in 2.4% (2 of 84) and mild vocal fold atrophy in 1.2% (1 of 84). CONCLUSION: Percutaneous steroid injection is a useful alternative modality for treating benign vocal fold lesions without morbidity. However, recurrence rates were higher with voice abuse after PSI and professional voice users. LEVEL OF EVIDENCE: 4. Laryngoscope, 126:2315-2319, 2016.