Treatment Outcomes of Intralesional Steroid Injection for Refractory Vocal Process Granuloma

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2024-08-12 DOI:10.1111/coa.14210

Po-Jun Yu, Wei-Chen Hung, Chi-Te Wang

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引用次数: 0

Abstract

Objectives

Vocal process granuloma (VPG) is a chronic condition resulting from a mucoperichondrial injury of vocal process. Initial conservative treatment typically involves vocal hygiene education and antireflux medication. Treatment challenges arise with refractory cases. Outcomes of second-line treatments such as surgical excision and botulinum toxin injections remain inconsistent. Thus, we propose this study to investigate the effectiveness of intralesional steroid injections for refractory VPG.

Methods

We conducted a retrospective review of 23 patients with VPG who showed no improvement after 3 months of proton pump inhibitors. These patients underwent one to three courses of monthly in-office intralesional steroid injections as a second-line therapy. Treatment outcomes were evaluated by measuring the size of the VPG relative to the length of the vocal folds before and after the final injection procedure.

Results

Results showed a significant reduction in VPG size from baseline of 27.74 ± 15.06 to 5.48 ± 8.95 (p < .001). 15 out of 23 patients were responsive (size reduction ≥ 75%) to intralesional steroid injection. Alcohol consumption and longer symptom duration were associated with a poor response (size reduction <75%), whereas prior intubation was associated with better response.

Conclusions

For refractory VPG not responding to conservative treatment, intralesional steroid injection appears to be a promising alternative option without significant adverse effects.

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鞘内注射类固醇治疗难治性声带肉芽肿的疗效。

目的：声带肉芽肿（VPG）是一种由声带粘膜软骨损伤引起的慢性疾病。最初的保守治疗通常包括声带卫生教育和抗反流药物。难治性病例会给治疗带来挑战。手术切除和肉毒杆菌毒素注射等二线治疗的效果仍不一致。因此，我们提出了这项研究，以调查区域内类固醇注射治疗难治性 VPG 的有效性：我们对服用质子泵抑制剂 3 个月后仍无改善的 23 名 VPG 患者进行了回顾性研究。作为二线疗法，这些患者每月接受一至三个疗程的诊室内类固醇注射。通过测量最终注射前后 VPG 相对于声带长度的大小来评估治疗效果：结果显示，VPG 的大小从基线的 27.74 ± 15.06 显著减小到 5.48 ± 8.95（p < .001）。23 名患者中有 15 名对局部注射类固醇有反应（体积缩小≥ 75%）。饮酒和症状持续时间较长与反应不佳（面积缩小）有关：对于保守治疗无效的难治性 VPG，局部注射类固醇似乎是一种前景看好且无明显不良反应的替代方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.