Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan.
Laryngoscope. 2014 Feb;124(2):510-5. doi: 10.1002/lary.24328. Epub 2013 Oct 2.
OBJECTIVES/HYPOTHESIS: This study intends to objectively quantify and compare the regression rates of vocal lesions in patients receiving either vocal fold steroid injection (VFSI) or vocal hygiene education (VHE). Potential influence of occupational vocal demands on the treatment outcome was also investigated.
Retrospective case series.
This study enrolled 176 patients of vocal nodules and vocal polyps. Ninety-two patients received VFSI, while 84 patients received VHE. We measured the lesion area with correction by the length of vocal fold, according to videolaryngoscopic examinations before treatment and 1 and 2 months after treatment.
VFSI was associated with a higher lesion reduction rate than VHE at 1 and 2 months (P <0.05). In vocal nodules and patients with ordinary occupational vocal demands, VFSI achieved a higher lesion regression rate than VHE at 1 month (P <0.05), while both modalities resulted in similar lesion reduction rates at 2 months (P >0.05). In vocal polyps, the lesion reduction rate after VFSI was higher than that following VHE at 1 and 2 months (P <0.01). In patients with high occupational vocal demands, the lesion sizes decreased significantly at 1 and 2 months following VFSI (P <0.01), but not for those receiving VHE (P >0.05).
VHE remains the fundamental strategy for all dysphonic patients, while VFSI can be applied alternatively. Both VFSI and VHE are effective for vocal nodules and patients with ordinary occupational vocal demands, but VFSI achieves lesion regression earlier than VHE. VFSI is preferred over VHE for vocal polyps and patients with high occupational vocal demands.
目的/假设：本研究旨在客观地量化和比较接受声带类固醇注射（VFSI）或嗓音保健教育（VHE）的患者的病变消退率。还研究了职业嗓音需求对治疗结果的潜在影响。
回顾性病例系列。
这项研究纳入了 176 名声带小结和声带息肉患者。92 名患者接受了 VFSI，84 名患者接受了 VHE。我们根据治疗前和治疗后 1 个月和 2 个月的视频喉镜检查，通过声带长度校正来测量病变面积。
VFSI 在 1 个月和 2 个月时的病变减少率均高于 VHE（P<0.05）。在声带小结和普通职业嗓音需求的患者中，VFSI 在 1 个月时的病变消退率高于 VHE（P<0.05），而在 2 个月时两种方法的病变减少率相似（P>0.05）。在声带息肉患者中，VFSI 治疗后的病变消退率在 1 个月和 2 个月时均高于 VHE（P<0.01）。在职业嗓音需求较高的患者中，VFSI 治疗后 1 个月和 2 个月时病变大小明显减小（P<0.01），而接受 VHE 的患者则没有明显减小（P>0.05）。
VHE 仍然是所有声音障碍患者的基本策略，而 VFSI 可以作为替代方法。VFSI 和 VHE 对声带小结和普通职业嗓音需求的患者均有效，但 VFSI 比 VHE 更早实现病变消退。VFSI 优于 VHE 适用于声带息肉和职业嗓音需求较高的患者。
4 级。
