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Comparison of benign lesion regression following vocal fold steroid injection and vocal hygiene education

Authors

  • Chi-Te Wang MD, MPH,

    1. Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
    2. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
    3. Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
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  • Li-Jen Liao MD, MPH,

    1. Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
    2. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
    3. Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
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  • Mei-Shu Lai MD, PhD,

    1. Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
    2. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
    3. Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
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  • Po-Wen Cheng MD, PhD

    Corresponding author
    1. Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan
    2. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
    3. Center of Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
    • Send correspondence to Po-Wen Cheng, MD, PhD, Department of Otolaryngology, Far Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Pan Chiao, Taipei, Taiwan E-mail: powenjapan@yahoo.com.tw

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  • This study was supported by a research grant from the National Science Council, Taipei, Taiwan (Grant No. NSC 101-2314-B-418-005). The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

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.

Study Design

Retrospective case series.

Methods

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.

Results

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).

Conclusions

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.

Level of Evidence

4. Laryngoscope, 124:510–515, 2014

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