Long-term Surveillance Following Intralesional Steroid Injection for Benign Vocal Fold Lesions

Wang, Chi‐Te; Lai, Mei‐Shu; Cheng, Po‐Wen

doi:10.1001/jamaoto.2016.4418

Cited by 36 publications

(25 citation statements)

References 45 publications

(110 reference statements)

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“…In this study, we noticed 16 recurring lesions (33%), a rate similar to our previous publication . Moreover, we found an interesting bimodal distribution regarding the timing of recurrence.…”

Section: Discussionsupporting

confidence: 90%

“…In this study, we noticed 16 recurring lesions (33%), a rate similar to our previous publication. 5 Moreover, we found an interesting bimodal distribution regarding the timing of recurrence. In 7 patients, vocal MRC recurred with a short interval between 3-7 months after VFSI (Appendix).…”

Section: Recurrence Of Vocal Mrcs After Vfsi and Its Possible Mechamentioning

confidence: 70%

“…Although our previous studies have reported the potential application of VFSI as an alternative treatment option for vocal fold MRCs, the effectiveness of VFSI was not validated because of the lack of control group. Meanwhile, recurrences after VFSI for vocal MRCs had been reported, but the risk factors had not been investigated before. Accordingly, we conducted this study and reported our updated series to fill the knowledge gaps among current literature.…”

Section: Introductionmentioning

confidence: 99%

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Intralesional steroid injection as an alternative treatment for 57 patients of vocal fold mucus retention cysts

Cheng

et al. 2018

Clinical Otolaryngology

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Section: Discussionsupporting

confidence: 90%

Section: Recurrence Of Vocal Mrcs After Vfsi and Its Possible Mechamentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

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Intralesional steroid injection as an alternative treatment for 57 patients of vocal fold mucus retention cysts

Cheng

et al. 2018

Clinical Otolaryngology

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“…Injectable steroids that were reported include: dexamethasone sodium phosphate (0.4 mg/0.1 mL), 4,25 triamcinolone acetonide (4 mg/0.1 mL), 28 and a 1:1 mixture of triamcinolone acetonide and dexamethasone sodium phosphate. 27 When injecting triamcinolone, the surgeon must be aware of possible depositions in the vocal folds. • Postoperative voice rest of up to 3 days is often recommended.…”

Section: General Considerationsmentioning

confidence: 99%

“…• Postoperative voice rest of up to 3 days is often recommended. 4,27 • Adverse events reported include vocal fold hematoma and atrophy. Atrophy may present with breathiness, bowing, and decreased amplitude on stroboscopy, which generally improves after 2 months.…”

Section: General Considerationsmentioning

confidence: 99%

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

et al. 2018

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Objectives To review available information regarding in‐office procedures for benign vocal fold lesions (BVFL). Methods PubMed term search on office/awake laryngeal procedures for any of the following specific lesions: Reinke's edema (RE), polyps, nodules, varices, vocal process granuloma, and vocal fold (VF) scar. Results In‐office ablative and nonablative laser procedures have been described for BVFL, including RE, polyps, varices, and granuloma. Fiber‐based lasers used include potassium titanyl phosphate, pulsed dye laser, and more recently CO2. In‐office intralesional steroid injection (ISI) for BVFL targets the inflammatory process involved with the lesion and may induce regression of polyps, nodules, RE, and granuloma. Botulinum toxin‐induced “voice rest” has been described as adjunctive treatment for refractory VF nodules or vocal process granuloma. Most in‐office techniques for treating BVFL rely on induction of lesion regression rather than complete lesion removal, as in conventional operative microsurgery. When treating VF scarring, in‐office procedures aim to alter the wound‐healing process; ISI targets the inflammatory phase and angiolytic lasers target the proliferative phase. Conclusion In‐office procedures for BVFL apply new technology that can potentially lower risk and cost. Although numerous case series have shown the potential of these procedures, data that thoroughly compares outcomes with those of microlaryngoscopic techniques is needed. Laryngoscope, 129:2131–2138, 2019

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Assessment of Patient Outcomes After Adjuvant Vocal Fold Steroid Injection for Fibrosis After Microlaryngeal Surgery

Hsu

Liao

Huang

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Microlaryngeal surgery (MLS) is one of the most common procedures in laryngology; however, in cases of postoperative fibrosis, few remedial options are available.OBJECTIVE To investigate the outcomes of vocal fold steroid injection (VFSI) as an adjuvant treatment for fibrosis after MLS. DESIGN, SETTING, AND PARTICIPANTS Case series of 228 consecutive patients who underwent MLS for benign vocal lesions between January 2014 and December 2016 at a tertiary medical center. Adjuvant VFSI was performed in 25 patients (11%) with postoperative fibrosis, defined as severely decreased or absent mucosal wave on videolaryngostroboscopy (VLS) lasting for longer than 1 month postoperatively. Data were analyzed from July 1, 2018 to April 30, 2019.INTERVENTION All adjuvant VFSIs were performed in the office under local anesthesia and were repeated monthly if the status of the mucosal wave did not return to normal or mildly decreased on the follow-up VLS. MAIN OUTCOMES AND MEASURESThe outcome parameters, namely, the 10-item Voice Handicap Index (VHI-10), smoothed cepstral peak prominence (CPP) of recorded voice samples, and mucosal wave status on VLS, were measured before and after MLS and after adjuvant VFSI. RESULTSIn this case series of 228 patients (72 men and 156 women; mean [SD] age, 42.8 [12.3] years), 25 had a decreased or absent mucosal wave after MLS, indicating postoperative fibrosis. Of these patients, 22 presented with deep-seated lesions that were removed using a microflap approach. After 1 course of adjuvant VFSI in 17 patients and 2 serial monthly injections in 8 patients, VFSI was associated with improved VHI-10 scores (mean, 24.4 points preoperatively, 22.1 points postoperatively, and 12.9 points after VFSI) that were comparable to the scores of the other 203 patients without vocal fold fibrosis after MLS (mean, 24.8 points preoperatively, 11.7 points postoperatively). Adjuvant VFSI was also associated with improved CPP (mean, 4.04 preoperatively, 4.23 postoperatively, and 5.11 after VFSI) that was comparable to the CPP of the other patients without postoperative fibrosis (mean, 4.33 preoperatively and 5.15 postoperatively). Overall, 19 (76%) of 25 patients with vocal fold fibrosis after MLS had normal (n = 11) or mildly decreased (n = 8) mucosal wave after adjuvant VFSI.CONCLUSIONS AND RELEVANCE Adjuvant VFSI appeared to be associated with improvements in mucosal wave, voice quality, and subjective perception of dysphonia in patients with fibrosis after MLS, with outcomes comparable to those of the other patients without fibrosis. Adjuvant VFSI may be considered a rescue technique, reducing the rate of fibrosis after MLS from 11% to 3%.

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Long-term Surveillance Following Intralesional Steroid Injection for Benign Vocal Fold Lesions

Cited by 36 publications

References 45 publications

Intralesional steroid injection as an alternative treatment for 57 patients of vocal fold mucus retention cysts

Intralesional steroid injection as an alternative treatment for 57 patients of vocal fold mucus retention cysts

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

Assessment of Patient Outcomes After Adjuvant Vocal Fold Steroid Injection for Fibrosis After Microlaryngeal Surgery

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