Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.
Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Voice. 2022 Mar;36(2):277-282. doi: 10.1016/j.jvoice.2020.05.018. Epub 2020 Jun 25.
Vocal process granuloma (VPG) has a varied treatment success rate and may frustrate patients and physicians due to poor outcomes. There is still a lack of standard protocols to manage VPG. This study aimed to review the efficiency of a standardized low-dose laryngeal electromyographic (LEMG)-guided botulinum toxin A (BTA) injection in intractable vocal granulomas.
Twenty-four patients with intractable VPG were recruited. All patients underwent percutaneous LEMG-guided BTA injection on the thyroarytenoid-lateral cricoarytenoid muscle complex in an office setting. The injecting dose was standardized to 1 U in 0.1 mL normal saline at a time. We evaluated the treatment effect by measuring the lesion size with serial laryngoscope evaluations.
The postinjection follow-up time varied from 3 to 23 months. Twenty-one patients (87.5%) experienced complete regression of the granuloma over 1-7 months (median 3 months). No major adverse effects were noted during the follow-up period.
For recalcitrant VPG, LEMG-guided low-dose BTA injection has the potential to be a safe, efficient, and effective treatment.
声带皱襞肉芽肿（VPG）的治疗成功率不一，治疗效果不佳可能会使患者和医生感到沮丧。目前仍缺乏管理 VPG 的标准方案。本研究旨在评估标准化低剂量喉肌电图（LEMG）引导下肉毒毒素 A（BTA）注射治疗难治性声带肉芽肿的疗效。
招募了 24 例难治性 VPG 患者。所有患者均在局麻下接受经皮 LEMG 引导下甲状软骨-环杓侧肌复合体的 BTA 注射。每次注射剂量标准化为 0.1mL 生理盐水内 1U。我们通过连续喉镜评估测量病变大小来评估治疗效果。
注射后随访时间为 3 至 23 个月。21 例患者（87.5%）在 1 至 7 个月（中位数 3 个月）内完全消退。随访期间无重大不良反应。
对于复发性 VPG，LEMG 引导下低剂量 BTA 注射具有安全、有效和高效的治疗潜力。
