Office-Based Steroid Injection in Benign Vocal Fold Lesions

Abstract

Background: Benign vocal fold lesions (BVFLs) are usually caused by vocal abuse or misuse. Conservative treatment and micro laryngeal surgery (MLS) are recommended in the treatment. However, conservative measures are usually difficult to perform and some patients are contraindicated for general anesthesia. Objective: This study is designed to assess the practical application, effectiveness, and side effects of office-based steriod injection via a transnasal route. Patients and Methods: This study included 29 patients with BVFLs. Transnasal endoscopic steroid injection (TESI) was performed via operating channel for all patients. Local anesthesia was used to inject betamethasone into Reinke's space at the base of the lesion. Acoustic analysis, including fundamental frequency (F0), jitter, shimmer, noise to a harmonic ratio (NHR), aerodynamic analysis (MPT), auditory perceptual assessment using modified GRBAS scale, videolaryngostroboscopy (VLS) evaluations, and voice handicap index (VHI), was done before and three months after TESI. Results: Three months after injection, the VLS demonstrated that remission in size or lesions improvement was observed in 20 patients, total disappearance in 4 patients, and no improvement in 5 patients. The summation of the modified GRBAS scale also indicated highly significant improvement after TESI (P < 0.01). MPT showed a highly significant increase post-injection. VHI showed a highly significant reduction post-injection. Acoustic analysis revealed significant improvements in F0, jitter, shimmer, and NHR (P <0.05). Conclusion: : Office-based TESI is an effective, safe, easy, and feasible alternative treatment method in some BVFLs.