Transnasal endoscopic steroid injection: A practical and effective alternative treatment for benign vocal fold disorders
Resource
Laryngoscope, 123(6), 1464-1468
Journal
Laryngoscope
Journal Volume
123
Journal Issue
6
Pages
1464-1468
Date Issued
2013
Author(s)
Wang, Chi-Te
Lai, Mei-Shu
Liao, Li-Jen
Lo, Wu-Chia
Cheng, Po-Wen
Abstract
Objectives/Hypothesis Emerging literature has documented the effectiveness of intralesional steroid injection as an alternative treatment for benign vocal fold disorders. However, clinical application is frequently limited by the associated technical demands for adequate anesthesia and precise needle placement. This study investigated the applicability and effectiveness of the more practical and less technically demanding method of transnasal endoscopic steroid injection (TESI). Study Design Prospective case series. Methods This study recruited 30 patients with vocal nodules and polyps. Dexamethasone was injected into the Reinke's space under local anesthesia via the operating channel of a transnasal flexible laryngoscope in an office setting. Treatment outcome were measured before, 1 month after, and 3 months after the injection, using videolaryngostroboscopy (VLS), maximal phonation time (MPT), 10-item voice handicap index (VHI-10), acoustic analysis, and perceptual evaluation. Results VLS examinations at 3 months post-treatment demonstrated that vocal lesions of 10 and 19 patients were resolved or reduced, respectively. Objective measurements showed increased MPT and decreased VHI-10 (P <.05 and P <.01, respectively). Acoustic analysis revealed significant decrease in jitter and shimmer (P <.05). Perceptual evaluation using the GRB (grade, roughness, breathiness) scale also showed improved voice quality (P <.01). Treatment outcomes were similar between vocal nodules and polyps (P >.05). Mild vocal hematoma occurred in three patients following TESI, but resolved spontaneously within 1 month. Conclusions TESI is a simple and practical office-based treatment modality for benign vocal fold lesions, suitable for most otolaryngologists. Treatment outcomes showed significant subjective and objective improvements that were comparable to the results of other injection procedures reported in the literature. ? 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Subjects
Dexamethasone; laryngoscope; larynx; vocal nodule; vocal polyp
SDGs
Other Subjects
dexamethasone sodium phosphate; acoustic analysis; adult; aged; article; atrophy; clinical article; drug efficacy; female; fibrosis; flexible laryngoscope; hematoma; human; infection; injection; local anesthesia; male; measurement; phonation; polyp; priority journal; prospective study; recurrent disease; scar formation; steroid therapy; transnasal endoscopic steroid injection; treatment outcome; vocal cord disorder; vocal nodule; vocal polyp; voice; Adult; Aged; Dexamethasone; Endoscopy; Female; Follow-Up Studies; Glucocorticoids; Humans; Injections, Intralesional; Male; Middle Aged; Nose; Phonation; Prospective Studies; Stroboscopy; Treatment Outcome; Vocal Cords; Voice Disorders; Young Adult
Type
journal article
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