Wu Chien-Hao, Lo Wu-Chia, Liao Li-Jen, Kao Yi-Chia, Wang Chi-Te
Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan.
Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
J Voice. 2023 May;37(3):472.e1-472.e6. doi: 10.1016/j.jvoice.2021.02.002. Epub 2021 Mar 8.
Current treatments for benign vocal lesions consist mainly voice therapy and phonomicrosurgery. However, these options are not always suitable for professional voice users because of their tight performance schedule and limited time for voice rest. This study investigated vocal fold steroid injection (VFSI) as an alternative treatment.
Matched case series.
We retrospectively enrolled 28 professional voice users (i.e., singers, actors and news anchors) who received VFSI for vocal nodules and polyps in an office setting of a tertiary teaching hospital. Outcomes were evaluated using videolaryngostroboscopy (VLS), the 10-item Voice Handicap Index (VHI-10), maximum phonation time, and acoustic and perceptual analyses before and 1 month after VFSI. Study results were compared with 56 patients of nonprofessional voice users (i.e., routine or high occupational vocal demands), matched in a 1:2 ratio by age, sex, and treatment date.
After VFSI, VLS revealed substantial lesion resolution in 82% professional voice users. One professional voice user developed a self-limited vocal fold hematoma after VFSI. VHI-10 scores in the professional group decreased from 21 to 14 points, compared with 23 to 16 points in the non-professional group, demonstrating a significant within-group effect (P < 0.01, GEE) and a nonsignificant between-group effect (P = 0.86). Other outcomes also improved significantly after VFSI (P < 0.05), without significant differences between the two groups.
VFSI can be an effective and safe alternative treatment for professional voice users with benign vocal lesions.
目前治疗良性声带病变的方法主要包括嗓音治疗和显微喉手术。然而，由于职业嗓音使用者的演出日程安排紧凑且嗓音休息时间有限，这些治疗方法并不总是适合他们。本研究调查了声带类固醇注射（VFSI）作为一种替代治疗方法的效果。
配对病例系列研究。
我们回顾性纳入了28名职业嗓音使用者（即歌手、演员和新闻主播），他们在一家三级教学医院的门诊接受了VFSI治疗声带小结和息肉。在VFSI治疗前及治疗后1个月，使用电子喉镜频闪喉镜检查（VLS）、10项嗓音障碍指数（VHI-10）、最长发声时间以及声学和感知分析来评估治疗效果。研究结果与56名非职业嗓音使用者（即日常或高职业嗓音需求者）进行比较，这些非职业嗓音使用者在年龄、性别和治疗日期方面按1:2的比例进行匹配。
VFSI治疗后，VLS显示82%的职业嗓音使用者病变得到显著缓解。一名职业嗓音使用者在VFSI治疗后出现了自限性声带血肿。职业组的VHI-10评分从21分降至14分，而非职业组从23分降至16分，显示出显著的组内效应（P < 0.01，广义估计方程）和不显著的组间效应（P = 0.86）。VFSI治疗后其他指标也有显著改善（P < 0.05），两组之间无显著差异。
对于患有良性声带病变的职业嗓音使用者，VFSI可以是一种有效且安全的替代治疗方法。
