Author(s)
Anthony Ghanem, MD
Elie Khalifee, MD
Abdul Latif Hamdan, MD, MPH, EMBA
Affiliation(s)
Department of Otorhinolaryngology, Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
Abstract:
Introduction: The reform in laryngology practice towards office-based laryngeal surgery has offered many treatment options for patients with benign vocal fold lesions.
Objective: To report on the outcome of intralesional steroid injections in patients with benign vocal fold lesions in an awake setting.
Methods: A retrospective chart review of patients who underwent office-based intralesional steroid injections between May 2019 and October 2021 in a tertiary referral center was conducted. Voice outcome measures included the Voice Handicap Index-10 (VHI-10) questionnaire, perceptual evaluation using the GRBAS scale, and acoustic analysis. Vocal fold lesions were evaluated using indirect laryngeal endo/stroboscopy before and after therapy.
Results: A total of 19 patients were included in this study. The mean age was 40.1?15.3 years, with 63% of the participants being males. Fifteen patients had bilateral injections and 1 patient required a second injection. The total number of procedures was 20 with a total of 36 injections performed. There was a significant decrease in the mean VHI-10 (16.26?6.48 before vs. 5.79?5.41 after) and in the means of all perceptual parameters (p<0.01). There was also a non-significant decrease in the means of the perturbation parameters on acoustic analysis. Laryngeal examination showed complete or partial regression of the lesions in 90% of the cases (18 out of 20 procedures). Endostroboscopy (n=12) showed improvement in glottal closure in 3 of 4 patients, and improvement in extent of mucosal waves in 7 of 11 patients.
Conclusion: Intralesional steroid injections in awake setting is an effective treatment alternative for patients with benign vocal fold lesions.