Local Steroid Injection via the Cricothyroid Membrane in Patients With a Vocal Nodule

Abstract

A local steroid injection via the cricothyroid membrane is a useful and safe treatment option for vocal nodules. However, vocal nodules are caused mainly by excessive voice use; therefore, nodules can recur unless the voice use pattern changes. Further study of this treatment technique, including long-term follow-up, is needed.

Comprehensive Outcome Researches of Intralesional Steroid Injection on Benign Vocal Fold Lesions

“…A previous study observed a 5% incidence rate of vocal fold atrophy after VFSI. 36 In contrast, this study revealed a much lower incidence rate (only one of 126 cases). One reasonable explanation for this discrepancy is the different injection approaches.…”

“…For vocal nodules, we demonstrated that VFSI can result in significant subjective and objective improvements ( Table 1, left column), which was comparable with previously published results. 11,36 Moreover, we investigated the prognostic factors of vocal nodules after VFSI, which had not previously been done. The study results demonstrated that patients with higher vocal demand were more likely to perceive higher phonation discomforts as measured by their postoperative VHI-10 scores ( Table 2, upper half).…”

“…14 For example, although triamcinolone's depot nature can result in longer duration of effectiveness within the injected site, 13 transient impairment of vocal fold vibration might occur after thick plaque formation of the injected triamcinolone, with incidence rates varying from 2.5% to nearly 100%. 36,46,47 Such inconsistent results might be explained by different time frames for postoperative visits. Because the triamcinolone is mostly absorbed gradually, it was likely that subjects returning to the clinic earlier were more likely to reveal such adverse effects than subjects who return to the clinic after 1-2 months.…”

Smad3: An emerging target for vocal fold fibrosis

“…In contrast, the treatment of vocal fold scar remains suboptimal. The one exception may be localized steroid injections, which have been reported to show modest, unreliable success in limited case series . We posit that an ideal therapy for vocal fold fibrosis must have targeted and predictable control of both the inflammatory and subsequent fibroplastic phenotype.…”

In‐office procedures for the treatment of benign vocal fold lesions in the awake patient: A contemporary review

“…ISI for VF nodules has been reported in retrospective and prospective case series. Complete resolution rates range between 31% to 44%, with partial regression of 49% to 69% . Whereas most patients demonstrated lesion response to treatment within 1 month, some patients improve only after 3 treatments .…”