Hamdan Abdul-Latif, Hosri Jad, Daou Christophe Abi Zeid, Ghzayel Lana, Hadi Jaafar, Saab Mounir Bou, Kasti Maher, Mourad Marc
Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
J Voice. 2024 May 17. doi: 10.1016/j.jvoice.2024.03.023.
To present the authors' experience on intralesional steroid injection (ILSI) for benign lesions of the vocal folds and a review of the literature.
Retrospective chart review.
The medical records of patients with vocal folds nodules, polyps, Reinke's edema, laryngitis/localized edema, and vocal fold granuloma who underwent ILSI were reviewed. Disease regression was assessed by reviewing the video recordings of laryngeal endoscopy before and after surgery. Subjective and objective voice outcome measures were compared before and after office-based ILSI.
Forty-seven patients with 81 lesions were included. The most common lesion treated was Reinke's edema followed by vocal fold nodules. All patients who presented for follow-up (n = 37) had partial or complete regression of their disease. When stratified by disease type, vocal fold polyps showed the highest percentage of complete regression (66.7%) followed by vocal fold nodules (65%). The mean voice handicap index-10 (VHI-10) score of the study group dropped from 16.63 ± 6.95 to 6.21 ± 6.09 points (P < 0.001). Patients with vocal fold polyps had the highest drop in the mean VHI-10 score by 16.66 ± 4.73 (P = 0.026). There was no significant difference in the mean acoustic and aerodynamic parameters before and after office-based steroid injection.
ILSI is an effective treatment modality for benign lesions of the vocal folds leading to partial or complete disease regression and self-reported improvement in voice quality.
介绍作者关于病灶内注射类固醇（ILSI）治疗声带良性病变的经验并进行文献综述。
回顾性图表审查。
回顾接受ILSI治疗的声带小结、息肉、任克氏水肿、喉炎/局限性水肿及声带肉芽肿患者的病历。通过查看手术前后的喉镜视频记录评估疾病消退情况。比较门诊ILSI前后的主观和客观嗓音结果指标。
纳入47例患者的81个病灶。最常治疗的病灶是任克氏水肿，其次是声带小结。所有前来随访的患者（n = 37）病情均有部分或完全消退。按疾病类型分层时，声带息肉的完全消退率最高（66.7%），其次是声带小结（65%）。研究组的平均嗓音障碍指数-10（VHI-10）评分从16.63±6.95降至6.21±6.09分（P < 0.001）。声带息肉患者的平均VHI-10评分下降最多，为16.66±4.73（P = 0.026）。门诊类固醇注射前后的平均声学和空气动力学参数无显著差异。
ILSI是治疗声带良性病变的有效方法，可导致疾病部分或完全消退，并自我报告嗓音质量改善。
